By Dirk Felleman
Journal of Social Work Values and Ethics
Spring 2005
Abstract
The increasing preference for technological therapies in health care is perceived by many as a serious threat to the future of socially based therapies. While this concern is not without merit there is another more hopeful possibility to be found in recent adaptations in the ethical evolution of medical practices. In particular the inclusion of pragmatism into clinical ethics holds the possibility of a mutually beneficial relationship between clinical social workers and medical professionals.
Introduction
Unlike other mental health professions, like medicine and clinical psychology, which gain their professional authority through their expert status as masters of scientifically based techniques of diagnosis and treatment, social work does not produce its own tools and so is not a ‘true’ profession in the classic sense. Social work has attempted to bolster its self-image by investing in academic ventures creating journals and doctoral programs but the standard in academia is still one of scientific knowledge and this leaves social work to imitate sociology and or psychology raising legitimate institutional questions of the value of such duplication. Likewise in the realm of professional practice, which is now almost exclusively run by corporate health conglomerates, the scientific techniques of medicine and psychology can be measured in terms of outcome equations, relating to statistical norms, which easily translate into the bookkeeping practices of the business sector, leaving social workers to serve these professions or find a new source of professional identity. This essay will offer social work an alternative vision for the future by calling on the resources of pragmatism, not to try and mimic or co-opt the applied sciences by creating an alternative and or inclusive foundation, but more like a work of art which allows one to appreciate a familiar scene in a new way.
The entire article is here.
Tuesday, January 14, 2014
Monday, January 13, 2014
How the brain heals emotional wounds: the functional neuroanatomy of forgiveness
Ricciardi E, Rota G, Sani L, Gentili C, Gaglianese A, Guazzelli M and Pietrini P (2013)
How the brain heals emotional wounds: the functional neuroanatomy of forgiveness.
Front. Hum. Neurosci. 7:839. doi: 10.3389/fnhum.2013.00839
In life, everyone goes through hurtful events caused by significant others: a deceiving friend, a betraying partner, or an unjustly blaming parent. In response to painful emotions, individuals may react with anger, hostility, and the desire for revenge. As an alternative, they may decide to forgive the wrongdoer and relinquish resentment. In the present study, we examined the brain correlates of forgiveness using functional Magnetic Resonance Imaging (fMRI). Healthy participants were induced to imagine social scenarios that described emotionally hurtful events followed by the indication to either forgive the imagined offenders, or harbor a grudge toward them. Subjects rated their imaginative skills, levels of anger, frustration, and/or relief when imagining negative events as well as following forgiveness. Forgiveness was associated with positive emotional states as compared to unforgiveness. Granting forgiveness was associated with activations in a brain network involved in theory of mind, empathy, and the regulation of affect through cognition, which comprised the precuneus, right inferior parietal regions, and the dorsolateral prefrontal cortex. Our results uncovered the neuronal basis of reappraisal-driven forgiveness, and extend extant data on emotional regulation to the resolution of anger and resentment following negative interpersonal events.
The entire article is here.
How the brain heals emotional wounds: the functional neuroanatomy of forgiveness.
Front. Hum. Neurosci. 7:839. doi: 10.3389/fnhum.2013.00839
In life, everyone goes through hurtful events caused by significant others: a deceiving friend, a betraying partner, or an unjustly blaming parent. In response to painful emotions, individuals may react with anger, hostility, and the desire for revenge. As an alternative, they may decide to forgive the wrongdoer and relinquish resentment. In the present study, we examined the brain correlates of forgiveness using functional Magnetic Resonance Imaging (fMRI). Healthy participants were induced to imagine social scenarios that described emotionally hurtful events followed by the indication to either forgive the imagined offenders, or harbor a grudge toward them. Subjects rated their imaginative skills, levels of anger, frustration, and/or relief when imagining negative events as well as following forgiveness. Forgiveness was associated with positive emotional states as compared to unforgiveness. Granting forgiveness was associated with activations in a brain network involved in theory of mind, empathy, and the regulation of affect through cognition, which comprised the precuneus, right inferior parietal regions, and the dorsolateral prefrontal cortex. Our results uncovered the neuronal basis of reappraisal-driven forgiveness, and extend extant data on emotional regulation to the resolution of anger and resentment following negative interpersonal events.
The entire article is here.
For human rights to flourish, religious rights have to come second
In Britain, discriminatory attitudes – to racism, to women, to homosexuality – have changed quickly and profoundly. But are religious beliefs now hampering progress?
By Deborah Orr
The Guardian
Originally posted December 27, 2013
There is certainly no shortage of one thing in the world, and that's a lack of goodwill to all men. And women. And children. If it isn't Russia introducing laws against homosexuality, then it's Saudi Arabia resisting the idea that women should drive cars. If it isn't Burma, spoilt for choice, decade after decade, as to which ethnicity to cleanse, then it's a bunch of African countries extolling female genital mutilation.
And outrageous as these horrors are, even the countries that we in the UK see as our natural allies, and consider as sharing our values, are hardly perfect. The US clings to capital punishment, thwarted only by a lack of the chemicals necessary to kill. Australia stands against gay marriage. Israel continues to favour the needs of settlers over established populations. Europe continues to harbour virulent antisemitism.
Britain is hardly without problems either. Hardly a day goes by without some giant, discriminatory insult provoking heated indignation.
The entire article is here.
By Deborah Orr
The Guardian
Originally posted December 27, 2013
There is certainly no shortage of one thing in the world, and that's a lack of goodwill to all men. And women. And children. If it isn't Russia introducing laws against homosexuality, then it's Saudi Arabia resisting the idea that women should drive cars. If it isn't Burma, spoilt for choice, decade after decade, as to which ethnicity to cleanse, then it's a bunch of African countries extolling female genital mutilation.
And outrageous as these horrors are, even the countries that we in the UK see as our natural allies, and consider as sharing our values, are hardly perfect. The US clings to capital punishment, thwarted only by a lack of the chemicals necessary to kill. Australia stands against gay marriage. Israel continues to favour the needs of settlers over established populations. Europe continues to harbour virulent antisemitism.
Britain is hardly without problems either. Hardly a day goes by without some giant, discriminatory insult provoking heated indignation.
The entire article is here.
Sunday, January 12, 2014
E.R. Costs for Mentally Ill Soar, and Hospitals Seek Better Way
By Julie Creswell
The New York Times
Originally published December 25, 2013
Here is an excerpt:
Today, North Carolina has only eight beds in state psychiatric hospitals per 100,000 people, the lowest ratio in the country.(North Carolina, like other states, has added beds in local community facilities but, even then, its total beds are down a quarter since 2001.)
Uninsured patients rarely receive individual therapy, only group sessions. And it can take up to three months to see a psychiatrist.
“Now, we are seeing some of the most acute, the most aggressive and the most chronic mental health patients, and we’re holding them longer,” said Janice Frohman, the director of WakeMed’s emergency department.
The effects of the upheaval in care of the mentally ill is playing out vividly at WakeMed. A private, nonprofit organization with 884 beds, WakeMed is struggling to find a way to meet the needs of increasing numbers of mentally ill patients while also controlling costs.
The entire article is here.
The New York Times
Originally published December 25, 2013
Here is an excerpt:
Today, North Carolina has only eight beds in state psychiatric hospitals per 100,000 people, the lowest ratio in the country.(North Carolina, like other states, has added beds in local community facilities but, even then, its total beds are down a quarter since 2001.)
Uninsured patients rarely receive individual therapy, only group sessions. And it can take up to three months to see a psychiatrist.
“Now, we are seeing some of the most acute, the most aggressive and the most chronic mental health patients, and we’re holding them longer,” said Janice Frohman, the director of WakeMed’s emergency department.
The effects of the upheaval in care of the mentally ill is playing out vividly at WakeMed. A private, nonprofit organization with 884 beds, WakeMed is struggling to find a way to meet the needs of increasing numbers of mentally ill patients while also controlling costs.
The entire article is here.
Collaboration Can Breed Overconfidence
Minds for Business
Psychological Science
Originally published November 20, 2013
The researchers found that people working with a partner were more confident in their estimates and significantly less willing to take outside advice. The pairs’ guesses were marginally more accurate than those of the individuals at first.
But after revision (or lack thereof), that difference was gone. Even the combined judgments of four people yielded no better results than those of two or three. Finally, the researchers found that had the pairs yielded to outside input, their estimates would have been significantly more accurate. Their confidence was costly.
The entire article is here.
Psychological Science
Originally published November 20, 2013
The researchers found that people working with a partner were more confident in their estimates and significantly less willing to take outside advice. The pairs’ guesses were marginally more accurate than those of the individuals at first.
But after revision (or lack thereof), that difference was gone. Even the combined judgments of four people yielded no better results than those of two or three. Finally, the researchers found that had the pairs yielded to outside input, their estimates would have been significantly more accurate. Their confidence was costly.
The entire article is here.
Saturday, January 11, 2014
The Healthcare Industry and the U.S.S.R.
By Jeanne Pinder
Ignite: Enlighten us, but make it quick
Uploaded December 16, 2013
Ignite: Enlighten us, but make it quick
Uploaded December 16, 2013
Why 'Cherry-Picking' Patients Is Gaining Ground
By Leigh Page
Medscape - Psychiatry
Originally published December 19, 2013
Lower reimbursements, busier practices, and the rise of outcomes-based payments are inciting more physicians to think about cherry-picking -- that is, selecting patients with better payments or fewer health problems. Many physicians admit they do it, although they may feel guilty about it, or they worry that being too aggressive in this realm could harm their practices and standing.
Health insurers have been well known for cherry-picking members, although new regulations have eliminated some of those behaviors. But physicians do some cherry-picking, too, said Jim Bailey, MD, a professor of internal medicine at the University of Tennessee Health Science Center in Memphis, who has written about the phenomenon. If you choose a higher-paying specialty or locate your offices in an affluent suburb, cherry-picking can be a factor in keeping your practice profitable, he said.
The entire article is here.
This article comes in four parts. You will need to click through in order to read the entire article.
Medscape - Psychiatry
Originally published December 19, 2013
Lower reimbursements, busier practices, and the rise of outcomes-based payments are inciting more physicians to think about cherry-picking -- that is, selecting patients with better payments or fewer health problems. Many physicians admit they do it, although they may feel guilty about it, or they worry that being too aggressive in this realm could harm their practices and standing.
Health insurers have been well known for cherry-picking members, although new regulations have eliminated some of those behaviors. But physicians do some cherry-picking, too, said Jim Bailey, MD, a professor of internal medicine at the University of Tennessee Health Science Center in Memphis, who has written about the phenomenon. If you choose a higher-paying specialty or locate your offices in an affluent suburb, cherry-picking can be a factor in keeping your practice profitable, he said.
The entire article is here.
This article comes in four parts. You will need to click through in order to read the entire article.
Friday, January 10, 2014
America Has an Incest Problem
By Mia Fontaine
The Atlantic
Originally posted January 24, 2013
Here is an excerpt:
Here are some statistics that should be familiar to us all, but aren't, either because they're too mind-boggling to be absorbed easily, or because they're not publicized enough. One in three-to-four girls, and one in five-to-seven boys are sexually abused before they turn 18, an overwhelming incidence of which happens within the family. These statistics are well known among industry professionals, who are often quick to add, "and this is a notoriously underreported crime."
Incest is a subject that makes people recoil. The word alone causes many to squirm, and it's telling that of all of the individual and groups of perpetrators who've made national headlines to date, virtually none have been related to their victims. They've been trusted or fatherly figures (some in a more literal sense than others) from institutions close to home, but not actual fathers, step-fathers, uncles, grandfathers, brothers, or cousins (or mothers and female relatives, for that matter). While all abuse is traumatizing, people outside of a child's home and family—the Sanduskys, the teachers and the priests—account for far fewer cases of child sexual abuse.
The entire article is here.
The Atlantic
Originally posted January 24, 2013
Here is an excerpt:
Here are some statistics that should be familiar to us all, but aren't, either because they're too mind-boggling to be absorbed easily, or because they're not publicized enough. One in three-to-four girls, and one in five-to-seven boys are sexually abused before they turn 18, an overwhelming incidence of which happens within the family. These statistics are well known among industry professionals, who are often quick to add, "and this is a notoriously underreported crime."
Incest is a subject that makes people recoil. The word alone causes many to squirm, and it's telling that of all of the individual and groups of perpetrators who've made national headlines to date, virtually none have been related to their victims. They've been trusted or fatherly figures (some in a more literal sense than others) from institutions close to home, but not actual fathers, step-fathers, uncles, grandfathers, brothers, or cousins (or mothers and female relatives, for that matter). While all abuse is traumatizing, people outside of a child's home and family—the Sanduskys, the teachers and the priests—account for far fewer cases of child sexual abuse.
The entire article is here.
Screening Newborns For Disease Can Leave Families In Limbo
By Nell Greenfieldboyce
NPR Health News
Originally posted December 23, 2013
For Matthew and Brianne Wojtesta, it all started about a week after the birth of their daughter Vera. Matthew was picking up his son from kindergarten when he got a phone call.
It was their pediatrician, with some shocking news. Vera had been flagged by New York's newborn screening program as possibly having a potentially deadly disease, and would need to go see a neurologist the next day.
Like every state, New York requires that newborns get a small heel prick so that a few drops of blood can be sent to a lab for testing. The idea is to catch health problems that could cause death or disability without early intervention.
But in recent years, patient advocacy groups have been pushing states to adopt mandatory newborn screening for more and more diseases, including ones that have no easy diagnosis or treatment.
One of those is Krabbe disease, a rare and devastating neurological disorder.
In 2006, New York became the first state to screen for Krabbe, and until recently it was the only state to do so. Screening for this disease is expanding, even though some experts say the treatment available doesn't seem to help affected children as much as was initially hoped — and testing can put some families in a kind of fearful limbo.
The entire story is here.
NPR Health News
Originally posted December 23, 2013
For Matthew and Brianne Wojtesta, it all started about a week after the birth of their daughter Vera. Matthew was picking up his son from kindergarten when he got a phone call.
It was their pediatrician, with some shocking news. Vera had been flagged by New York's newborn screening program as possibly having a potentially deadly disease, and would need to go see a neurologist the next day.
Like every state, New York requires that newborns get a small heel prick so that a few drops of blood can be sent to a lab for testing. The idea is to catch health problems that could cause death or disability without early intervention.
But in recent years, patient advocacy groups have been pushing states to adopt mandatory newborn screening for more and more diseases, including ones that have no easy diagnosis or treatment.
One of those is Krabbe disease, a rare and devastating neurological disorder.
In 2006, New York became the first state to screen for Krabbe, and until recently it was the only state to do so. Screening for this disease is expanding, even though some experts say the treatment available doesn't seem to help affected children as much as was initially hoped — and testing can put some families in a kind of fearful limbo.
The entire story is here.
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