Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Tuesday, October 9, 2012

Narrative, Poststructuralism, and Social Justice Current Practices in Narrative Therapy


By Gene Combs and Jill Freedman
The Counseling Psychologist

doi: 10.1177/0011000012460662
The Counseling Psychologist October 2012 vol. 40 no. 7 1033-1060


Abstract

This paper is a review of current practice in narrative therapy with a focus on how it is attractive and useful for therapists who wish to work for social justice. The authors describe narrative therapy’s roots in poststructuralist philosophy and social science. They illustrate its major theoretical constructs, including the narrative metaphor, Foucault’s notion of “modern power,” and narrative therapy’s emphasis on problems as separate from people. The authors then describe specific practices: narrative questions, externalizing conversations, utilizing the “absent but implicit,” the development and “thickening” of preferred stories, the documentation of preferred stories, outsider witness practices, and practices for connecting people around shared purposes. After reviewing research that supports narrative therapy as useful and effective, the authors specifically address the ways narrative therapy deals with issues of social justice, showing how its focus on the discourses of modern power helps therapists be especially attuned to these issues.

Contact information: Gene Combs, NorthShore University HealthSystem, 2050 Pfingsten Rd., Glenview, IL, 60026, USA

President Obama Unveils Landmark Actions To Fight Human Trafficking


The president said it was time to call human trafficking by its real name: "modern slavery."

By ELIZABETH FLOCK
US News and World Report
Originally published September 26, 2012


President Barack Obama unveiled major actions to fight human trafficking at home and abroad in a speech at the Clinton Global Initiative's annual meeting Tuesday, a problem the U.S. has long sought to control.

Just hours after his Republican challenger Mitt Romney spoke to the same audience, arguing broadly that free trade and aid were the key to a better world, Obama chose to focus his speech on the single issue of trafficking, and what the U.S. can do to stop it. Obama told the assembled audience it was time to turn the focus on fighting trafficking within American borders.

"The ugly truth is that this goes on right here," he said. "It's the migrant worker unable to pay off the debt to his trafficker... The teenage girl—beaten, forced to walk the streets. This should not be happening in America."

The president also said it was time to call human trafficking by its real name: "modern slavery." Obama's speech came just days after the 150th anniversary of the Emancipation Proclamation, the executive order issued by President Abraham Lincoln in 1863 that freed millions of slaves across the United States.

The entire story is here.

Monday, October 8, 2012

In Plain View: How child molesters get away with it.

By Malcolm Gladwell
The New Yorker
Originally published September 24, 2012

Here are some excerpts:

The pedophile is often imagined as the dishevelled old man baldly offering candy to preschoolers. But the truth is that most of the time we have no clue what we are dealing with. A fellow-teacher at Mr. Clay’s school, whose son was one of those who complained of being fondled, went directly to Clay after she heard the allegations. “I didn’t do anything to those little boys,” Clay responded. “I’m innocent. . . . Would you and your husband stand beside me if it goes to court?” Of course, they said. People didn’t believe that Clay was a pedophile because people liked Clay—without realizing that Clay was in the business of being likable.

Did anyone at Penn State understand what they were dealing with, either? Here was a man who built a sophisticated, multimillion-dollar, fully integrated grooming operation, outsourcing to child-care professionals the task of locating vulnerable children—all the while playing the role of lovable goofball. “If Sandusky did not have such a human side,” Sports Illustrateds Jack McCallum wrote, in 1999, “there would be a temptation around Happy Valley to canonize him.” A week later, Bill Lyon, of the Philadelphia Inquirer, paid tribute to Sandusky’s selflessness. “In more than one motel hallway, whenever you encountered him and offered what sounded like even the vaguest sort of compliment, he would blush and an engaging, lopsided grin of modesty would wrap its way around his face,” Lyon wrote. “He isn’t in this business for recognition. His defense plays out in front of millions. But when he opens the door and invites in another stray, there is no audience. The ennobling measure of the man is that he has chosen the work that is done without public notice.”

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This is standard child-molester tradecraft. The successful pedophile does not select his targets arbitrarily. He culls them from a larger pool, testing and probing until he finds the most vulnerable. Clay, for example, first put himself in a place with easy access to children—an elementary school. Then he worked his way through his class. He began by simply asking boys if they wanted to stay after school. “Those who could not do so without parental permission were screened out,” van Dam writes. Children with vigilant parents are too risky. Those who remained were then caressed on the back, first over the shirt and then, if there was no objection from the child, under the shirt. “The child’s response was evaluated by waiting to see what was reported to the parents,” she goes on. “Parents inquiring about this behavior were told by Mr. Clay that he had simply been checking their child for signs of chicken pox. Those children were not targeted further.” The rest were “selected for more contact,” gradually moving below the belt and then to the genitals.

The child molester’s key strategy is one of escalation, desensitizing the target with an ever-expanding touch. In interviews and autobiographies, pedophiles describe their escalation techniques like fly fishermen comparing lures.

The entire story is here.

Thanks to Rick Small for this story.

A Dangerous Remedy (2 Letters)


Two Letters to the Editor from the New York Times published on October 1, 2012.

One is important to understand how psychotropics are currently being used on a daily basis and the second to underscore how psychological treatments are overlooked.

To the Editor:

Re “A Call for Caution on Antipsychotic Drugs,” (Mind, Sept. 25): “A call for caution” is indeed needed and long overdue to curb the inappropriate overuse of antipsychotics. As the author notes, the use of these highly potent and expensive drugs is drastically out of proportion to the appropriate target population: individuals with schizophrenia and bipolar disorder.

The misuse of antipsychotics in nursing homes in particular is a widespread yet preventable problem. Approximately one in four residents are given antipsychotics. The percentage of residents with dementia on these drugs is even higher. Too often, they are used as a form of chemical restraint, as a substitute for good care and adequate staffing. Contrary to what the article states, they are harmful for elderly people with dementia, greatly increasing the risk of stroke, heart attack, falls and even death.

Federal standards have long prohibited the inappropriate use of antipsychotics in nursing homes. With increased public knowledge and vigorous enforcement, hopefully we can make those standards a reality for vulnerable residents.

Richard Mollot

Manhattan

To the Editor:

There was no mention in Dr. Richard A. Friedman’s article about the proven effectiveness of psychological treatment, such as cognitive behavioral therapy, for nonpsychotic disorders. Instead, Dr. Friedman suggests that patients suffering from anxiety or depression take other, less powerful medications. By not recommending psychotherapy for the treatment of anxiety and depression, Dr. Friedman is perpetuating the mind-set that all psychiatric disorders should be treated with medicine, which in effect has created a climate that encourages the off-label use of antipsychotics.

Patricia Thornton

Manhattan

These can be found here.

Sunday, October 7, 2012

NYC schools dispensing morning-after pill to girls

By By Karen Matthewslindsey Tanner
Bloomberg BusinessWeek
Originally published September 26, 2012


 It's a campaign believed to be unprecedented in its size and aggressiveness: New York City is dispensing the morning-after pill to girls as young as 14 at more than 50 public high schools, sometimes even before they have had sex.

The effort to combat teen pregnancy in the nation's largest city contrasts sharply with the views of politicians and school systems in more conservative parts of the country.

Valerie Huber, president of the National Abstinence Education Association in Washington, calls it "a terrible case once again of bigotry of low expectations" — presuming that teen girls will have sex anyway, and effectively endorsing that.

But some doctors say more schools should follow New York's lead.

Emergency contraception is safe and effective "if you use it in a timely fashion. It provides relief or solace to a young woman or man who has made a mistake but doesn't want to have to live with that mistake for the rest of their lives," said Dr. Cora Breuner, a Seattle physician and member of an American Academy of Pediatrics' committee on teen health.

The entire story is here.

Illinois cannot make pharmacists give 'morning after' pill: court

By Mary Wisniewski
Reuters
Originally published September 21, 2012

An Illinois appellate court Friday affirmed a lower court finding that the state cannot force pharmacies and pharmacists to sell emergency contraceptives - also known as "morning after pills" - if they have religious objections.

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"We are dismayed that the court expressly refused to consider the interests of women who are seeking lawful prescription medication and essentially held that the religious practice of individuals trumps women's health care," said ACLU spokesman Ed Yohnka. "We think the court could not be more wrong."

The entire story is here.

Abortion Rates Fall When Birth Control Is Free


By Salynn Boyles
WebMD Health News 
Originally published on October 4, 2012


Abortions and unplanned pregnancies dropped dramatically in a new study when women and teenaged girls were provided birth control at no cost.

The women and girls were also more likely to choose IUDs or contraceptive implants when cost was not an issue.

Family planning advocates say the study shows the potential of the health reform law (now known by both supporters and opponents as Obamacare) to reduce unplanned pregnancies nationwide.

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About half of all pregnancies in the U.S. are unplanned, and about half of these pregnancies happen when birth control is not used.

The rest happen when contraception is used only some of the time or is used incorrectly.

The new study, published online today in the journal Obstetrics & Gynecology, included close to 9,300 sexually active women and teen girls at risk for having an unplanned pregnancy.

While the women were offered any FDA-approved method of contraception at no cost, the researchers made sure they knew that IUDs and implants were the most effective.

Researcher Jeff Peipert, MD, of Washington University in St. Louis, says around 3 out of 4 study participants opted for the long-acting methods.

“That was a shocker,” he says. “We had hoped to get maybe 15% of the women to choose IUDs or implants, but it was closer to 75%. That made all the difference.”

The entire story is here.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice opinion can be found here.

Saturday, October 6, 2012

Cheating

By Herman Berliner
Provost Prose Blog
Originally published September 23, 2012

Here is an excerpt:

Cheating doesn’t just start in college.  It starts much earlier and is equally pervasive in much of middle and high school education. It actually starts earlier in elementary school and unfortunately parents may be playing an enabling role in the cheating that is going on.  We all recognize that parents play a critical role in the education of their children and that teachers together with parents are key factors in the success of children.  But where should parents draw the line in helping their kids.  My wife and I both read to and listened to the reading of both of our kids when they were very young.  I hope we helped them read earlier and more fluently.  But we have never felt that their homework was our homework and we never hovered over them until their assignments were perfection.  And we never have felt that their grades are our grades and that we had to help them in any way possible to get the highest grade possible.

The entire blog post is here.

Cheating in College


By Scott Jaschik
Inside Higher Ed
Originally published on September 27, 2012


A scandal at Harvard University has many educators talking about cheating and whether anything can be done about it. Experts say that many students arrive in college already skilled at and not morally troubled by cheating, and scandals at top high schools back up this point of view. What, if anything, can professors and colleges? These issues are explored in a new book, Cheating at College: Why Students Do It and What Educators Can Do About It (Johns Hopkins University Press). The authors are Donald L. McCabe, professor of management and global business at the Rutgers University Business School; Kenneth D. Butterfield, associate professor of management, information systems and entrepreneurship at Washington State University; and Linda K. Treviño, professor of organizational behavior at Pennsylvania State University. They responded via e-mail to questions about the book.

Q: Is cheating getting worse? Or do those who say that only imagine a golden age when academic honesty prevailed?

A: Interestingly, the hard data we present in our book suggest cheating may now be on the decline. Similar results have been obtained by the Josephson Institute in their work with high schools. After a period of steep increases, some moderation in cheating was reported in their 2010 report. They will issue a new report in October 2012 and it will be most interesting to see what’s happening now. But, it is important to keep in mind that the data are self-reported and, in our studies, we have moved from print surveys to online surveys. That move may have affected the numbers we are seeing, possibly making the picture look rosier than it really is.

In our college work, we have observed a kind of ebb and flow in our data – some types of cheating seem to have increased (surprisingly not necessarily those related to the Internet) and others seem to be on the wane. However, there seems to be little question, based on various comments offered by students, that changes in student attitudes can’t be ignored. Many students have indicated that they have had no involvement in certain types of cheating, but in open-ended questions near the end of our survey, they say that they actually have engaged in these actions, but when they did it, it was not cheating because…. Of course, this may simply be a rationalization process so students don’t have to admit, maybe even to themselves, that they’ve actually cheated.

The entire story is here.