We conducted a rapid review and quantitative summary of meta-analyses that have examined interventions which can be used by individuals during quarantine and social distancing to manage anxiety, depression, stress and subjective well-being. A literature search yielded 34 meta-analyses (total number of studies k = 1,390, n = 145,744) that were summarized. Overall, self-guided interventions showed small to medium effects in comparison to control groups. In particular, self-guided therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based (...) interventions), selected positive psychology interventions, and multi-component and activity-based interventions (music, physical exercise) showed promising evidence for effectiveness. Overall, self-guided interventions on average did not show the same degree of effectiveness as traditional guided individual or group therapies. There was no consistent evidence of dose effects, baseline differences and differential effectiveness of eHealth interventions. More research on the effectiveness of interventions in diverse cultural settings is needed. (shrink)

The implementation of online technologies to promote wellbeing is increasingly becoming a worldwide priority. This study includes secondary analyses of data and examined drop-out rates in an online guided self-help intervention for patients with anorexia nervosa. Specifically, rates of drop-out at end of treatment (i.e. six-week assessment), as well as intervention adherence (minimum of four of six online guided sessions) and differences between completers and drop-outs were examined. Motivation to change and associated patient variables were assessed as (...) predictors of drop-out using structural equation modelling. Ninety-nine patients were randomised to the intervention arm of the trial. Data were available for 82 individuals, 67 of whom completed the six-week assessment and attended a minimum of four online sessions. No significant differences were found between completers and drop-outs at baseline. At the end of the first week of participation, drop-outs from the six-week assessment or the intervention reported less satisfaction with their work with the mentor delivering online guidance. Greater confidence in own ability to change and higher controlled motivation (willingness to change due to pressure from others) predicted lower drop-out rates from the six-week assessment. Stronger alliance with the therapist at the treatment centre and lower psychological distress were associated with greater autonomous motivation (self-directed motivation) and importance and ability to change. Data demonstrate that a novel online guided self-help intervention for patients with anorexia nervosa is feasible. Early satisfaction with the program and external pressure to change have a protective role against drop-out rates. (shrink)

Positive reappraisal strategies have been found to reduce negative affect following the recall of negative personal events. This study examined the restorative effect of two mood-repair instructions (self-compassion vs benefit-focused reappraisal) and a control condition with no instructions following a negative Mood Induction Procedure by using the guided recall of a negative autobiographical event. A total of 112 university students participated in the online study (81% women, Mage: 21.0 years). Immediately following the negative memory recall, participants were randomised (...) to each condition [(self-compassion: n = 36, benefit-focused: n = 39) or a control condition (n = 37)]. Repeated measures ANOVAs 3 (Repair condition) × 3 (Time of mood assessment: pre-recall, post-recall, post-regulation) showed that, as expected, negative mood (sadness, shame, and guilt) worsened significantly after the guided recall in all groups (p <.001). After the mood-repair intervention, participants in the self-compassion and benefit-focused conditions showed a significant reduction in negative mood (p <.019), while such improvement was not observed in the control group. Self-compassion and benefit-focused reappraisal functioned similarly as mood repair strategies after experiencing negative affect induced by the recall of negative personal memories. Implications in the context of autobiographical memory biases are discussed. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for (...) patients with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

When considering whether to enact or not to enact a tempting option, people often anticipate how their choices will make them feel, typically resulting in a “mixed bag” of conflicting emotions. Building on earlier work, we propose an integrative theoretical model of this judgment process and empirically test its main propositions using a novel procedure to capture and integrate both the intensity and duration of anticipated emotions. We identify and theoretically integrate four highly relevant key emotions, pleasure, frustration, guilt, and (...) pride. Whereas the former two (basic hedonic) emotions are anticipated to dissipate relatively quickly, the latter two (self-conscious) emotions are anticipated to be more long-lived. Regarding the relative weighting of emotions, we obtained evidence for a relative guilt bias and pride neglect under default conditions. Furthermore, we identify situational influences on this judgment process and find that rendering self-conscious emotions more situationally salient positively impacts self-control decision-making. We discuss how these findings build on an integrative theory of self-control and how they are useful for the design of choice environments and interventions. (shrink)

The impact of stress and other psychological variables on Inflammatory Bowel Disease prognosis, treatment response, and functional level is well-established; however, typical IBD treatment focuses on the physiological pathology of the disease and neglects complementary stress-reducing interventions. Recent pilot studies report the benefits of mindfulness-based interventions in people living with IBD, but are limited by small sample sizes. Recruitment challenges to in-person studies may be in part due to the difficulty IBD patients often have adhering to fixed schedules (...) and travel as a result of IBD symptoms such as pain, fatigue, and incontinence. The current study aimed to address this barrier by offering participants access to online mindfulness training, allowing individuals to engage with intervention materials to fit their own schedule. Online mindfulness programs have gained popularity in recent years, as they increase access and flexibility and decrease cost to the user; however, the dropout rate tends to be high. The current study compared the rate of adherence and efficacy of mindfulness training as a function of level of support: self-guided versus supported. Analysis revealed no significant difference in the benefits received between participants in the two groups; however, a significant difference group was found in terms of rate of completion, with 44.1% of the supportive group completing the protocol compared to 11.7% of the self-guided. Common challenges to meditation were measured, but did not significantly predict adherence to the intervention, and experience of these challenges did not significantly change over the duration of the study. Implications of the current research, future directions for the use of MBI for IBD patients, and a discussion of methodological considerations are provided. (shrink)

Positive Psychology Interventions as an Opportunity in Arab Countries to Promoting Well-being AbstractIn this perspective paper, we emphasize the importance of further research on culturally-sensitive positive psychology interventions in the Arab region. We argue that these interventions are needed in the region because they not only reduce mental health problems but also promote well-being and flourishing. To achieve this, we shed light on the cultural elements of the Arab region and how the concept of well-being differs from (...) that of Western culture. We review the research conducted in Arabia, briefly evaluate the quality of this research and list some adapted measurements. We furthermore propose guidelines and recommendations for future evidence-based positive psychology interventions research to align with the national culture in various sectors and community samples that contribute to the development of well-being in the Arab world.Introduction Extensive research on Positive Psychology Interventions (PPIs) - defined as activities focus on promoting positive feelings, thoughts, or behaviour (Sin & Lyubomirsky, 2009) - has shown their effectiveness in well-being and mental illness (e.g., Chakhssi et al., 2018; Hendriks et al., 2020). A recent review of 347 studies showed that PPIs have a significant effect on promoting quality of life and well-being and reducing anxiety and depression (Carr et al., 2020). However, the issue is that most of these studies (82%) remain narrow in focus only on Western Educated Industrialised Rich Democratic (WEIRD) countries (Hendriks et al., 2019). Therefore, they may not be effective for other countries such as the Arab countries where there are various cultural differences. This highlights the key role that culture can play in enhancing PPIs engagement, acceptability, and eventually, effectiveness (Hendriks & Graafsma, 2019). Recently, the field of PP in the Arab region has begun to grow (Basurrah et al., 2021; Rao et al., 2015). However, studies conducted in these countries are scant and of poor methodological quality. We have found humble quantity and quality of empirical studies. Yet, Arab countries, home to 5% of the world’s population, have a burden of mental health problems above global levels (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). Prevalent stigma, war and conflict were some of the contributors (Maalouf et al., 2019). Thus, to properly address this cultural stigma against mental health problems, PPIs could provide an additional role alongside traditional psychology approaches (e.g., Cognitive Behavioural therapy - CBT). Further, in light of the political conditions that some Arab countries are going through and the negative effects that they cause, it has become necessary to use the method of prevention that is the focus of PP and not only of treatment as a strategy for applications and practice. It has been noted that the mental health care system in the Arab region focuses highly on illnesses treatment and neglects the significant role that PP plays in enhancing human potential and well-being. We - here in Arabia –are becoming more influenced by many global issues particularly the COVID-19 pandemic and their impact on mental health and well-being (e. g. prevalence of stress, anxiety, depression among the general population during the pandemic (Salari et al., 2020). In response, Waters et al. (2021) have recently presented how positive psychological factors can play a significant role in buffering mental illness, enhancing mental health throughout the pandemic, and building positive processes and capacities that can help to promote future mental health.Here in this perspective paper, we highlight the cultural aspects of Arab countries. Specifically, we present previous PPIs research conducted in Arabia and briefly evaluate the quality of this research. Importantly, we discuss the need of developing an indigenous and culturally sensitive PP among the Arab region (Lambert et al., 2015).Arab Culture “Arab World,” which comprises 5% of the world’s population, refers to the Arab countries in the Middle East and North Africa. Despite the increasing pace and progress of different businesses in many Arab countries, individual communities are still limited in certain prominent economic places. Arab people rather gather in collective communities. They generally share the same Arabic Islamic culture, speak the same language, and descend from the same Arab families when going back in history no matter what nationality they have nowadays. Yet, very many changes came to communities before borders were drawn between countries and after. For instance, geography, topography, demography, and socio-economic status affect peoples’ nature of jobs and lifestyles. For example, Arabs in the east, west, or the middle have similar tongues; however, almost every Arab country has its accent. Therefore, people need to go back to the formal Arabic language ‘Fus-ha’ or learn more about different Arabic dialects when communicating cross-countries. According to Hofstede’s model (2011) based on the individualism-collectivism dimension, the Arab countries (Eastern society) have been classified as a collectivist culture, where their identity and decisions are influenced by social systems. In contrast, the United States (Western society) has been classified as an individualist culture focusing on individual decisions. Although there are degrees of individualism among Arabs in certain countries, they still share collective common characteristics. Here, we explore the meaning of collectivistic conceptions of the self, emotions, values, and religion in Arab countries and how they differ from those in individual Western cultures. The Self Since the field of PP focuses on the development of self, it is vital to recognize that self-concept varies across cultures. Individualism generally emphasises the self-directed and autonomous individual (Realo et al., 2002). People in individualist countries focus primarily on their personal characteristics (e.g., motives, abilities) to build their self-concept. On the other hand, collectivism refers to several social structures that highly value the groups to which people belong, such as family and tribe (Realo, 2003). People in collectivist countries such as the Arab countries focus primarily on their relationships with others to build their self-concept (Markus & Kitayama, 1991). Hence, research from Arab countries should focus on the core elements of collectivism when implementing PPIs to make a significant, meaningful impact. For example, people from a collective culture may experience a greater enhancement in well-being when practising interventions that are more prosocial and group-oriented such as compassion, performing acts of kindness, writing a gratitude letter, and using character strengths in everyday context including social context, compared with self-oriented interventions such as identifying character strengths. Emotions, value, and Religion Research shows that Western culture emphasises the goal of maximizing positive emotions, while Eastern culture emphasises embracing and balancing positive and negative emotions (Leu et al., 2011). To illustrate, culture plays an important role in influencing perceptions of happiness. People in individualist countries value happiness highly. In contrast, people from the collective countries value low arousal positive emotions (Leu et al., 2011) and exhibit a fear of happiness (Joshanloo & Weijers, 2014; Joshanloo, 2013). Hence, the influence of positive emotions plays a limited role in the mental health of Eastern society. Speaking of Value, for an Arab, the family is the centre of honour and the most important social unit. This loyalty has an impact on every part of an Arab’s life. Arabs honour their families and highly value their friendships. Therefore, future research could shed more light on group-oriented interventions (e.g., kindness) that focus more on the relationship with family, friends, and community. When it comes to religion, Arab society has a rich culture in values and believes that place a high emphasis on spirituality. Religion is the most important and distinctive aspect of Arab culture. Arab countries vary in terms of religion, with Islam being the predominant religion in most of them. Well-being (Hedonic and Eudaimonic) It is necessary here to clarify what is meant by hedonic and eudaimonic definitions of well-being. While the term ‘Hedonic’ is based on the pursuit of maximum levels of pleasure (feeling good), the term ‘Eudaimonic’, on the other hand, is based on meaning and the development of virtues (functioning well; Keyes & Annas, 2009). Research indicates that cultures are not equally supportive of hedonic and eudaimonic aspects (Joshanloo & Jarden, 2016). In comparison to collectivism, hedonism appears to be more congruent with individualism (Joshanloo, 2014). Pleasure and positive emotions are considered a way to pursue happiness in Western culture, while this method is not highly favoured in Eastern cultures (Lee et al., 2013); Because they consider suffering and negative emotions as contributing factors to spiritual development. Therefore, the eastern perspective is more in line with a eudaimonistic view which emphasises virtues, meaning, and feeling of belongingness. However, although we believe that both approaches can be found to a certain level in both cultures, the differences suggest that there are different routes to happiness. Positive Psychology in the Arab region Positive psychology - "the scientific study of what makes life most worth living" (Seligman & Csikszentmihalyi, 2000) - is one of the newest branches of psychology. It focuses on three main pillars: (1) positive subjective experiences (such as happiness and love); (2) positive individual characters (such as gratitude and compassion); and (3) positive institutions (for the application of positive principles within institutions and organizations; Seligman & Csikszentmiha lyi, 2000). Some of the main topics of interest in positive psychology include character strengths, gratitude, hope, happiness, mindfulness, optimism, positive thinking, and resilience. Within the applications of this science, various domains of well-being (such as happiness, engagement, positive emotions, and meaning) can be enhanced by practising positive psychology interventions (Sin & Lyubomirsky, 2009). Interestingly, these interventions have also produced benefits beyond well-being, such as reduced mental health issues (Chakhssi et al., 2018; Hendriks et al., 2020).Nowadays, PP is increasingly noticed in the Arab world (Lambert & Pasha-Zaidi, 2019; Rao et al., 2015). In recent years, there has been a great effort to explore the PP field across Arab countries. Several initiatives have emerged aimed at promoting well-being and flourishing. For example, the Middle East Journal of Positive Psychology published its first volume in 2015. On the International Day of Happiness in 2017, United Arab Emirates University launched its Emirates Center for Happiness Research. Meanwhile, Effat University in Saudi Arabia started the first Positive Psychology and Well-being Research Lab, the first symposium, and the first PP course. In 2019, Louise Lambert and Nausheen Pasha-Zaidi published the first regional text entitled “Positive Psychology in the Middle East/North Africa.” There are other efforts spent in the region as well; such as the work conducted in Egypt. Ibrahim Younus established the Arab Association for Positive Psychology https://www.psycholearn.com/en/associative.php which provides several courses on PP and also published a book entitled “The Power of Positive Psychology” (Younus, 2017). Despite this development, nothing can compare to the quantity and even quality of research in other countries. In light of our observations, the few PP studies may be attributed to the lack of awareness of the constructive approach and prevention compared to problem-solving. An Arab dentist once said: “people do not come to me until they are badly in pain.” In any case, many studies have taken place in Arab countries in the last decade, more of which are descriptive and less of which experimental. For example, Abdel-Khalek (2010) found positive correlations between quality of life, subjective well-being, and religiosity among students in Kuwait. Abdel-Khalek (2016) developed “the Arabic Scale of Religiosity,” which significantly correlated with PP variables among students in Algeria, Kuwait, and Egypt. Recently, empirical studies on PPIs have arisen in Arab-Islamic countries. More attention has been focused on promoting well-being and alleviating the high burden of mental health problems in the region (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). For instance, several studies examined the effectiveness of mindfulness among university students (e.g., Al-Ghalib & Slim, 2018; Awad, 2019; Thomas et al., 2016), parents of children with autism (Rayan & Ahmed, 2016) and addicted adults (Al-Rashidi, 2018). Such an intervention has positive effects. Participants who practised mindfulness reported reduction in stress and depression as well as improvement in well-being and resilience. Moreover, the results of a recent pilot study found positive impacts on enhancing emotional regulations and reducing stress among Arab teachers (Berkovich-Ohana et al., 2020). Some studies have also begun to examine various interventions targeting character strengths (Basurrah et al., 2020; Chérif et al., 2020), self-compassion (Elaiwah, 2017), positive thinking (Mohammed et al., 2014; Hadad, 2014), and hope (Zaki, 2016). Interestingly, a new finding considering the fear of happiness among people from collective countries has been examined. Lambert et al. (2019) provided evidence that a 14-week PPIs programme has an impact on reducing the fear and fragility of happiness beliefs among university students in the United Arab Emirates.Since Arab countries place great emphasis on spirituality, several authors have considered the aspect of religion when implementing PPIs. For instance, an empirical study by Al-Seheel and Noor (2016) found that expressing gratitude towards God “Allah” increases the happiness of the Muslim more than the usual gratitude intervention. Additionally, Al-Ghalib and Salim (2018) examined a religiously sensitive mindfulness-training programme with university students and found a positive effect on life satisfaction and a slight reduction in stress, depression, and anxiety. Hence, the role of religion is vital to make the interventions more relevant to Arab culture where people can connect Islamic philosophy with PP theories and practices. These studies reviewed here provide further support for the need for culturally sensitive interventions among the Arab population. More recently, the first systematic review of PPIs in Arab countries was conducted by Basurrah et al. (2021; the protocol has been published in BMJ Open and the final manuscript has been submitted for publication). Reviewing a total of 39 studies, the most commonly studied interventions were mindfulness, positive thinking, and resilience. Only a handful of studies examined gratitude, character strengths, forgiveness, self-compassion, savouring, or finding flow. Further analysis revealed that most studies from Arab countries have several methodological limitations. This included a lack of protocol guidelines, few well-designed randomized controlled trials (RCTs), blinding issues, small sample sizes, lack of active control groups, and lack of research into certain populations (e.g., teachers, employees, and people in distress in refugee camps). Discussion PP was founded on an individualistic framework (Christopher & Hickinbottom, 2008). To ensure that PPIs are culturally meaningful, this paper includes some cultural elements of the Arab region that should be considered to serve the needs of the Arab population. In the Arab world, some people may believe that PP is solely about happiness and being positive. If so, it is important to educate the public about the findings of rigorous studies evaluating PPIs such as gratitude, hope or flow on health, well-being and performance. To explain the value and effectiveness of these evidence-based approaches, examples might include studies linking gratitude with benefits for people with heart disease (Cousin et al., 2021), or how PPIs can promote quality of life in cancer patients (Casellas-Grau et al., 2014). There is some evidence about PPIs being effective in improving well-being in the Arab region, but research in this region is still in its infancy and little information is available regarding PPIs and the experience of Arabs participating in such interventions. Hence, there is still much more to investigate in this regard. Future research should empirically examine the effectiveness of various unstudied interventions such as savouring, gratitude, self-compassion, character strengths or finding flow. A combination of quantitative and qualitative approaches is required to provide an in-depth understanding of Arabs’ experience and impressions of PPIs and how and why they work. This may provide useful information to inform the appropriate design of PPIs to suit Arab culture and needs. Furthermore, while some research on PPIs has been carried out in the region, most of these studies have been of poor quality that suffered from small sample sizes, confounding factors, and a high degree of bias. To overcome these issues, future research should improve research quality, including protocol guidelines and well-designed RCTs. In particular, research should include randomization, allocation, blinding, power analysis to determine adequate sample size, active control groups to reduce bias, and follow-up periods of at least 12 months.Among the most popular resources that future PP practitioners may refer to are the International Positive Psychology Association (IPPA) and the International Positive Education Network (IPEN). Also, we recommend the Middle East Journal of Positive Psychology and the first regional book (Lambert & Pasha-Zaidi, 2019). To develop and/or adapt a multi-component PPIs, we would recommend referring to Character Strengths (Peterson & Seligman, 2004), the theory of well-being (PERMA Model: Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment; Seligman, 2011), and the Five Ways to Well-being: Connect, Be Active, Take Notice, Keep Learning, and Give (Aked et al., 2008). Finally, single-component PPIs are based on theories like Broaden-And-Build (Fredrickson, 2004), Hope (Snyder et al., 2002), and Self-Determination (Deci & Ryan, 2012) can be also considered. Two other concepts that would be usefully applied are ‘Savouring’ (Bryant & Veroff, 2007) and Phillip Zimbardo’s Time Perspective (Stolarski et al., 2015). For instance, savouring has a positive temporal orientation to reminiscing the good memories from the past, enjoying the hedonic present moments, and willing proactively to make a better future. Now, what is even maybe more interesting for Muslims is “Transcendent Future” where all intentions, words and actions are devoted to that life after death. In addition, there is a model already prepared for the clinical purpose called Positive Psychotherapy (PPT). Tayyab Rashid and Martin Seligman published a PPT manual for clinicians in 2018. And for cross-cultural applications, including Muslim Arab culture, Rashid and Al-Haj Baddar (2019) have written a paper presenting PPT and its efficacy. PPT overview in detail shows sessions, themes, skills, practice, and cultural considerations where a mixture of PPIs based on PERMA, Strengths, and other PP concepts can be found. Regarding PP measurements, it is highly recommended to generate indigenous tools based on cultural backgrounds reviewed here in the article. An example of this is a tool for measuring Muslim well-being by including domains beyond what is found in Western literature. So far, in the Arab region, several attempts have been made to adapt PP tools. For example, Marei Salama-Younes (2018) validated the Arabic versions of different measures of well-being (e.g., satisfaction with life scale, the subjective vitality scale). Other validated scales as well include the self-compassion scale (Alabdulaziz et al., 2020), and the passion scale (Salama-Younes & Hashim, 2018). Conclusion This paper has discussed the cultural aspects of Arab countries and the need of developing culturally sensitive PPIs. The past decade has seen an increase in mental health problems in the Arab region. Stigma and lack of awareness have been always there. Among the issues are also wars, conflicts, and displacement in many Arab countries such as Iraq, Lebanon, and Palestine (Hassan et al., 2016). These indicate an urgent need to prevent mental illness and promote well-being. Indeed, we highlighted the importance of integrating culture with PPIs, following the guidelines for the cultural adaptation of PPIs (Hendriks & Graafsma, 2019) and the ethical guidelines for PP practice (Jarden et al., 2020). Another significant contribution of this paper is to highlight the importance of improving the quality of research conducted in Arab countries. In brief, this paper has several practical implications. It is an open invitation for researchers, policymakers, and practitioners alike to be more exposed to PP; as well as to better conceptualising and adapting interventions and measurement tools to the local culture in different sectors to maximize their effectiveness. And as we consider it as an invitation for us too, here we are starting a PPIs practice guide in Arabic language and for Arab practitioners. The insights gained from this paper may be useful for placing well-being on top of priorities for achieving individual, organizational, and optimal national functioning in different sectors. There is also a need to change the stigma or negative beliefs about seeking health for psychological support, which is an issue for countries in the Middle East (Baess, 2018). (shrink)

Behavioural experiments are one of the central and most powerful methods of intervention in cognitive therapy. Yet until now, there has been no volume specifically dedicated to guiding physicians who wish to design and implement behavioural experiments across a wide range of clinical problems.The Oxford Guide to Behavioural Experiments in Cognitive Therapy fills this gap. It is written by clinicians for clinicians. It is a practical, easy to read handbook, which is relevant for practising clinicians at every level, from trainees (...) to cognitive therapy supervisors.Following a foreword by David Clark, the first two chapters provide a theoretical and practical background for the understanding and development of behavioural experiments. Thereafter, the remaining chapters of the book focus on particular problem areas. These include problems which have been the traditional focus of cognitive therapy, as well as those which have only more recently become a subject of study, and some which are still in their relative infancy. The book also includes several chapters on transdiagnostic problems, such as avoidance of affect, low self-esteem, interpersonal issues, and self-injurious behaviour. A final chapter by Christine Padesky provides some signposts for future development.Containing examples of over 200 behavioural experiments, this book will be of enormous practical value for all those involved in cognitive behavioural therapy, as well as stimulating exploration and creativity in both its readers and their patients. (shrink)

Many bioliberals endorse broadly consequentialist frameworks in normative ethics, implying that a progressive stance on matters of bioethical controversy could stem from outcome-based reasoning. This raises an intriguing empirical prediction: encouraging outcome-based reflection could yield a shift toward bioliberal views among nonexperts as well. To evaluate this hypothesis, we identified empirical premises that underlie moral disagreements on seven divisive issues (e.g., vaccines, abortion, or genetically modified organisms). In exploratory and confirmatory experiments, we assessed whether people spontaneously engage in outcome-based reasoning (...) by asking how their moral views change after momentarily reflecting on the underlying empirical questions. Our findings indicate that momentary reflection had no overall treatment effect on the central tendency or the dispersion in moral attitudes when compared to prereflection measures collected 1 week prior. Autoregressive models provided evidence that participants engaged in consequentialist moral reasoning, but this self-guided reflection produced neither moral “progress” (shifts in the distributions’ central tendency) nor moral “consensus” (reductions in their dispersion). These results imply that flexibility in people's search for empirical answers may limit the potential for outcome-based reflection to foster moral consensus. (shrink)

BackgroundParent-mediated intervention has been studied in promoting skill acquisition or behavior change in the children with autism spectrum disorder. Most studies emphasize on the improvement of child’s core symptoms or maladaptive behaviors, making parental perceived competence and self-efficacy secondary. Yet, the evaluations of intervention implementation are under-reported, especially when translating such interventions into a new population or context. This research investigated the intervention implementation of a 12-week parent coaching intervention which was delivered through telehealth and tailored to Chinese (...) population. The intervention was based on the Parent-mediated Early Start Denver Model with culturally adapted lectures, manuals, and demonstration and commentary videos. This study aimed to evaluate the intervention implementation by assessing parents’ satisfaction, acceptability, appropriateness, and feasibility.MethodA randomized controlled trial was conducted with two telehealth conditions: self-directed and web+group therapy. Parents in the self-directed condition received intervention individually through the online learning platform. The web+group therapy condition navigated the same program with weekly 1.5-h group coaching sessions via videoconferencing. This mixed-methods study used a concurrent convergent design to evaluate the intervention implementation at post-intervention. The quantitative data was collected from the Program Evaluation Survey and the qualitative data was collected from five focus groups.ResultsParents in self-directed group reported significantly lower scores in total perceived competence than parents in web+group therapy condition, while there was no group difference on the total self-efficacy. Tailored feedback, demonstration and commentary videos, peer commenting, live coaching, and guided reflection were the top-five acceptable telehealth strategies that were strongly endorsed by parents. Family centered care, home-based intervention, strategies relative to daily activities, the remote learning platform, and the program-based community were elements that parents considered when evaluating the program’s appropriateness. Parent modeling, step-by-step instructions, and tailored feedback were key components in making intervention strategies feasible for parents to implement at home.ConclusionFindings indicate the application of telehealth was acceptable, appropriate, and feasible for Chinese parents. Group-based parent coaching intervention via videoconferencing could be a promising home-based service model to increase parental perceived competence. A large-scale RCT is needed to investigate the effectiveness of group-based PMI via telehealth. (shrink)

The Ethics of Humanitarian Intervention: An Introduction offers a guide to the ethical debates surrounding armed humanitarian intervention. It is ideal reading for students and researchers in philosophy, applied ethics, politics and international relations.

Adolescent smartphone addiction has increasingly attracted the attention of scholars because of the widespread use of internet technology in educational environments. In addition, previous studies have found that there is a complex relationship between smartphone addiction and self-consistency congruence, and subjective well-being. This research was conducted to examine whether subjective well-being would mediate the relation between self-consistency congruence and adolescent smartphone addiction, and whether gender would moderate the mediating process. A total of 1,011 Chinese adolescents completed self-report (...) questionnaires measuring self-consistency congruence, subjective well-being, and smartphone addiction. Self-consistency congruence was shown to be a significant predictor of smartphone addiction. Furthermore, subjective well-being partially mediated the association between self-consistency congruence and adolescent smartphone addiction. Gender could moderate the mediating process; as compared with boys, girls’ self-consistency congruence and subjective well-being are more easily mediated. We envision the findings as being helpful in guiding scholars who are developing interventions to minimize smartphone addiction and its disrupting effects in adolescents. (shrink)

Despite the numerous benefits associated with forgiveness, many individuals find it difficult to forgive. This is especially true in organizations, where forgiveness is rare and can be under-valued. Across two studies, we explore how to facilitate forgiveness within organizational contexts and in the aftermath of workplace unfairness. We examine whether individuals can reduce the “injustice gap” that can be created by violations and enhance forgiveness through expressive writing interventions—guided writing techniques that can be self-administered. Participants wrote about (...) their reactions to a fictional scenario or an actual workplace experience. Results indicate that expressive writing was associated with higher reported perceived resolution. Whereas negative emotions mediated this relationship in Study 1, positive emotions and perceived injustice mediated this relationship in Study 2. Perceived resolution also mediated the relationship between expressive writing and forgiveness. Theoretical, methodological, and practical implications are discussed. (shrink)

Zoos attract millions of visitors every year, many of whom are schoolchildren. For this reason, zoos are important institutions for the environmental education of future generations. Empirical studies on the educational impact of environmental education programs in zoos are still rare. To address this issue, we conducted two studies: In study 1, we investigated students’ interests in different biological topics, including zoos ( n = 1,587). Data analysis of individual topics revealed large differences of interest, with advanced students showing less (...) interest in zoos. In study 2, we invited school classes of this age group to visit different guided tours at the zoo and tested connection to nature before and after each educational intervention ( n = 608). The results showed that the guided tours are an effective tool to raise students’ connection to nature. Add-on components have the potential to further promote connection to nature. The education programs are most effective with students with a low initial nature connection. (shrink)

Mentalizing - the ability to understand oneself and others by inferring the mental states that lie behind overt behavior - develops during childhood within the context of a secure attachment relationship. It is crucial to self-regulation and constructive, intimate relationships. Failure to retain mentalizing, particularly in the midst of emotional interactions, is a core problem in borderline personality disorder and results in severe emotional fluctuations, impulsivity, and vulnerability to interpersonal and social interactions. Mentalization-based treatment for borderline personality disorder is (...) a 'How to Do It' book outlining a clinically proven treatment for Borderline Personality Disorder. Containing illustrative clinical examples, it details precisely how to develop and implement treatment and is a companion to the highly successful book Psychotherapy for Borderline Personality Disorder - mentalization based treatment. This practical guide explains how to treat borderline patients by helping them develop a more robust mentalizing capacity within the context of an attachment relationship. It provides the practitioner with everything they need to know about how to practise mentalizing treatment in day patient and out-patient settings. Enough theory is provided to orientate the clinician and there is step-by-step practical advice on the assessment of mentalizing and interpersonal relationships, how to structure treatment, the use of basic mentalizing interventions and how to apply them, as well as information on what not to do. In addition, it includes a check list to be used in the assessment of mentalizing and a self-rating exercise for practitioners to evaluate their adherence to mentalizing. (shrink)

Ukraine's war of self-defense against Russia is one of the clearest examples of a nation fighting a just war in recent history. Ukraine is clearly entitled to defend itself, and Russia is clearly obligated to cease hostilities, withdraw troops, and make repair. In light of this, some of the most salient moral questions related to Russia's war of aggression in Ukraine involve the international community; namely, what moral duties it has toward Ukraine, especially in light of Russia's extreme and (...) pervasive human rights abuses. The first section of the essay argues that there is a pro tanto moral duty to intervene militarily in Ukraine to stop Russian human rights abuses and ensure that Ukraine achieves a military victory. This duty is grounded in duties of rescue, promissory obligations, and reliance obligations, as well as duties to nations’ own citizens and to the international community. The second section of the essay argues that the most relevant consideration in determining whether there is an all-things-considered duty for the international community to intervene militarily in Ukraine is Russia's nuclear coercion and the associated risk of nuclear war. This section highlights the nuclear risks involved in compliance with Russian nuclear coercion, which I argue have been neglected in prominent discussions. The moral stakes involved in this determination are very high, and succumbing to Russian nuclear coercion in the face of massive human rights violations would set a dangerous precedent. Any course of action should be guided by a thorough analysis of all the risks involved, both nuclear and moral. (shrink)

Coaching is a systematic and goal-oriented one-on-one intervention by a coach aimed to guide clients in their professional and personal development. Previous research on coaching has demonstrated effects on a number of positive outcomes, including well-being and performance, yet little is known about the processes that underlie these outcomes, such as the type of questions coaches use. Here, we focus on three different types of coaching questions, and aim to uncover their immediate and sustained effects for affect, self-efficacy, and (...) goal-directed outcomes, using a between-subjects experiment. One hundred and eighty-three medical residents and PhD students from various medical centers and healthcare organizations in the Netherlands were recruited to participate in a self-coaching writing exercise, where they followed written instructions rather than interacting with a real coach. All participants were randomly allocated to one of three conditions: either one of two solution-focused coaching conditions or a problem-focused coaching condition. Self-report questionnaires were used to measure key outcomes of coaching, that is positive and negative affect, self-efficacy, goal orientation, action planning and goal attainment. Two follow-up measurements assessed if the effects of the self-coaching exercise led to problem-solving actions within an initial follow-up period of 14 days and a subsequent follow-up period of 10 days. Findings showed that participants experienced more positive affect, less negative affect, and higher approach goal orientation after the solution-focused coaching exercise compared to the problem-focused coaching exercise. In all conditions, goal attainment increased as a consequence of the self-coaching intervention. We discuss the implications of our findings for the science and practice of contemporary coaching. (shrink)

BackgroundThis study aimed to determine what, how, and under what circumstances individual-focused interventions improve well-being and decrease burnout for critical care healthcare professionals.MethodThis realist approach, expert opinion interview, was guided by the Realist And Meta-narrative Evidence Synthesis: Evolving Standards II guidelines. Semi-structured interviews with critical care experts were conducted to ascertain current and nuanced information on a set of pre-defined individual interventions summarized from a previous umbrella review. The data were appraised, and relationships between context, mechanisms, and (...) outcomes were extracted, which created theory prepositions that refined the initial program theory.ResultsA total of 21 critical care experts were individually interviewed. By understanding the complex interplay between organizational and personal factors that influenced intervention uptake, it was possible to decipher the most likely implementable intervention for critical care healthcare professionals. The expert recommendation suggested that interventions should be evidence-based, accessible, inclusive, and collaborative, and promote knowledge and skill development. Unique mechanisms were also required to achieve the positive effects of the intervention due to the presence of contextual factors within critical care settings. Mechanisms identified in this study included the facilitation of self-awareness, self-regulation, autonomy, collaboration, acceptance, and inclusion.ConclusionThis validation of a theoretical understanding of intervention that addressed well-being and burnout in critical care healthcare professionals by expert opinion demonstrated essential mechanisms and contextual factors to consider when designing and implementing interventions. Future research would benefit by piloting individual interventions and integrating these new theoretical findings to understand better their effectiveness for future translation into the “real-world” setting. (shrink)

Background: Both anxiety and depression in family caregivers of advanced cancer patients are common, and they have a negative influence on both the FCs and the patients. Some studies suggested that a variety of interventions could alleviate the psychological symptoms of FCs. However, there is no consensus on much more effective methods for intervention, and relatively high-quality research is blank in psychological problems of these population in China. The validity of mindfulness-based stress reduction and psychological consultation guided by (...) the needs assessment tool in the psychological status of caregivers will be compared in this study to select a more suitable intervention for the FCs of advanced cancer patients in China.Methods and Analysis: A randomized N-of-1 trial would be conducted at the Cancer Hospital, Chinese Academy of Medical Sciences. Fifty eligible FCs of advanced cancer patients will be recruited, and all will receive three cycles of psychological intervention treatment, with each cycle including both of MBSR and psychological consultation guided by the NST. MBSR and psychological consultation guided by the NST will be compared with each other in each cycle, and the intervention sequence will be based on the random number table generated after the informed consent has been completed. Each treatment period is 2 weeks, and the interval between different treatment cycles or treatment periods is 1 week. The self-reported scales are measured at the beginning and end of each treatment period, including the Self-Rating Anxiety Scale, the Self-Rating Depression Scale, Distress Thermometer, Zarit Burden Interview, Chinese version of the Medical Outcomes Study 12-item Short Form, and Family Carer Satisfaction with Palliative Care scale.Dissemination: The protocol of the study was approved by the Institutional Review Board of the Ethical Committee of the Cancer Hospital, Chinese Academic of Medical Science. The results will be published in a peer-reviewed medical journal. The study is registered at Chinese Clinical Trials Registry with the trial registration number chiCTR2000033707. This study employs an innovative methodological approach on the effectiveness of MBSR and psychological consultation guided by the NST for psychological status of FCs of advanced cancer patients. The findings of the study will be helpful to provide high-quality evidence-based medical data for psychological intervention of FCs of advanced cancer patients, and guide clinicians on best quality treatment recommendations. (shrink)

This paper situates Günther Anders’s diagnosis of a shift in the modes of human self-production from hermeneutic and educational practices to techno-scientific interventions in the broader context of observations concerning posthumanism and biopolitics (e.g. Peter Sloterdijk, Giorgio Agamben). It proposes to reframe the problem of human self-production within the philosophy of media and traces a common anti-hermeneutic trajectory to which both technoscientific transhumanism and certain strands of posthumanism belong, insofar as they are based on an ontology that (...) exclusively considers causally effective agency. With Anders and Martin Heidegger it is argued that such a focus on agency neglects the dimension of meaning that irreducibly guides technoscientific interventions. The paper claims that, with regard to the escalating dynamics both of human enhancement and of the Anthropocene, neither a truly critical theoretical stance nor a practical subversion is possible without taking the horizons of meaning into account that drive these dynamics. The last section sketches an outline of the complex interrelations of humans, technologies and meaning that cannot be mapped in terms of causally effective agency. (shrink)

A co-creation values consumers’ input as its primary crust in informing businesses on current consumer needs. More importantly, it would be the next shape in future demands of consumers in business sustainability. This paper addressed this context, narrowing its scope in investigating the voices of stakeholders on what would be the essential aspects of the present and future youth qualities in achieving sustainable well-being in the present trend. The findings would be essentially helpful for the youth and the business world (...) to understand the aspects of good youth development, which would shape the next fabric of consumerism. Self-potential development of the youth is vital in achieving excellent life quality and the youth’s well-being in Malaysia. However, the increase in challenges faced by today’s youth is inconsistent with a decline of the group’s well-being. There are various studies and interventions implemented to overcome the youth situation. However, there is still in need for a model that can guide the holistic development of youth self-potential. The purpose of this study is to build a sustainable and comprehensive model of the self-potential development of the youth, which can be integrated with all of the self-potential indicators of the youth via a co-creation process. This study used the Fuzzy Delphi Method on the proposed elements in the development model and systematically analyzed them using Interpretive Structural Modeling to create the development model. The method capitalized 10 stakeholders from various youth development backgrounds in developing the model. The model consists of 25 sub-indicators that are divided into five indicators. The model findings show that one of the most driving indicators is an entrepreneurial mindset among youth, followed by the other indicators of youth self-potential development. The model also shows that the civic-mindedness indicator is the output of youth self-potential that will surface at an end of the development. The model will guide the authorized body on the priority elements that can systematically and strategically improve youth self-potential to meet future challenges with youth aspirations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumThe Self-Fulfilling Prophecy of Police BrutalityKathryn Petrozzo (bio)In their timely and pressing piece, Arjun Byju and Phoebe Friesen explore the contentious diagnosis of excited delirium; a syndrome characterized by erratic, aggressive, and “delusional” behavior (2023). Overwhelmingly, this term is used when individuals come in contact with police and/or first responders. Although much attention has been given to debating whether or not this is a “real” diagnosis, the (...) authors want to shift the focus to examining the work that excited delirium is doing in the world, as well as the underlying beliefs guiding it that are perpetuating substantial harm. Drawing significantly on the work of Ian Hacking (1998, 2006) and Sherene Razack (2015), Byju and Friesen explore what kinds of people are being made up by the label of “excited delirium” and the subsequent dehumanization that perpetuates violence towards those in this grouping.Despite the lack of an agreed upon definition, excited delirium tends to frequently group together young Black men and other marginalized people of color, who have a psychiatric history, and those who have taken or are suspected to have taken drugs (Byju & Friezen, 2023). As this is “observed” when individuals come into contact with law enforcement and/or first responders, those who are presumed to be suffering from excited delirium are typically met with physical restraints (chokeholds, hogties, etc.), forced injections of sedatives, and/or taser guns. The violent reactions are often justified not only by this “diagnosis,” but the employment of racial stereotypes; notably, the notion that Black bodies as being less susceptible to pain. As the authors aptly put it:This kind of symptom language helps make up the novel category of a person who suffers from excited delirium: a crazed and inhumane monster, a golem that must be met with unrelenting and superordinate force, who is fated, regardless of interventions, to die a spontaneous death. This paradox, that those with excited delirium are supposedly both too strong and too weak, is at the core of the illness narrative.(2023)It is evident that this label is reinforcing the combination of two harmful stereotypes: the notion that those suffering from severe mental illness occupy a space that is “less than fully human,” and racist stereotyping of Black bodies “superseding human strength.” This perpetuates total dehumanization of the individual, where it is then justified to invoke brutal tactics, as well as signal [End Page 357] to the greater community this is how individuals with mental illnesses and/or belonging to a particular racial group (chiefly, Black men), should be treated. This is despite the fact that those suffering from mental illnesses are significantly more likely to be victims of violent crimes, Black Americans are 3.2 times more likely to be murdered by police, and convergence of these factors (being Black and living with a mental illness) increases likelihood of such fatal interactions (Schwartz & Jahn 2020; Shadravan, Edwards, & Vinson 2021; Stuart, 2003).Although I am in wholehearted support of their account, I take issue with the authors’ conceptualization of excited delirium as non-falsifiable, as well as the notion that diseases, generally, are falsifiable. In an attempt to further criticize the utilization of excited delirium, Byju and Friesen call upon Karl Popper’s falsifiability criterion as a measure for what constitutes as scientific; arguing that excited delirium is not a legitimate scientific concept as it is impossible to falsify. First, I am not convinced that excited delirium is in principle non-falsifiable; as the way in which it’s conceptualized actually appears to be falsifiable. The authors point out that external factors, such as tasing and violent restraints, are clearly the causal explanation, which should in fact, lead one to reject the hypothesis of an excited delirium diagnosis. However, in practice, those who are seeking to exonerate the police/first responders responsible for these deaths, are not accepting this evidence leading them to reject the excited delirium diagnosis, but rather, are crafting an incorrect causal narrative. This is deeply problematic, but it does not necessarily render excited delirium as non-falsifiable. More broadly, I am concerned with the reliance on the falsifiability criterion, which has been widely criticized in the... (shrink)

Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only (...) to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit between local thinking and external behavior possibilities entails a deep understanding of tacit and explicit attitudes, values, knowledge as well as physical and social environments, best gained via inclusive and polycentric policy approaches. (shrink)

Adaptive behavior critically depends on performance monitoring, the ability to monitor action outcomes and the need to adapt behavior. PM-related brain activity has been linked to guiding decisions about whether action adaptation is warranted. The present study examined whether PM-related brain activity in a flanker task, as measured by electroencephalography, was associated with adaptive behavior in daily life. Specifically, we were interested in the employment of self-control, operationalized as self-control failures, and measured using ecological momentary assessment. Analyses were (...) conducted using an adaptive elastic net regression to predict SCFs from EEG in a sample of 131 participants. The model was fit using within-subject averaged response-locked EEG activity at each electrode and time point within an epoch surrounding the response. We found that higher amplitudes of the error-related negativity were related to fewer SCFs. This suggests that lower error-related activity may relate to lower recruitment of interventive self-control in daily life. Altered cognitive control processes, like PM, have been proposed as underlying mechanisms for various mental disorders. Understanding how alterations in PM relate to regulatory control might therefore aid in delineating how these alterations contribute to different psychopathologies. (shrink)

Chronic obstructive pulmonary disease (COPD) is one of the most deadly and costly chronic diseases in the world characterized by many breathing problems. The management of COPD and the prevention of exacerbations are a priority goals to improve the quality of life in patients affected by this illness. In addition, it is also crucial to improve the patients’ adherence to care which, in turn, depends on their knowledge and understanding of some factors such as the prescribed medical treatment, changes in (...) dailylife, and the process of breathing. In turn, the adherence to care leads to greater autonomy for the patient who is thus able to better manage his illness. Here we presented the application of the Model IARA in patients affected by COPD in order to achieve their autonomy in illness management which, in turn, leads to a better quality of life. IARA is an intervention program which improve the awareness and knowledge of patients with respect to both the disease and symptoms through health education. Moreover, through IARA the patients are encouraged to become more actively involved in COPD care process, also regarding drug therapy adherence. Using St. George's Respiratory Questionnaire combined with qualitative analysis, we demonstrated that IARA could be considered a useful approach in COPD management. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly demonstrates (...) that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

Ecologically valid procedures for eliciting and measuring children's anger are needed to enhance researchers' theories of children's emotional competence and to guide intervention efforts aimed at reactive aggression. The purpose of this article is to describe a laboratory-based game-playing procedure that has been used successfully to elicit and measure children's anger across observational, physiological, and self-report channels. Steps taken to ensure that participants are treated ethically and fairly are discussed. The article highlights recently published data that emphasize the importance (...) of provoking and assessing children's anger across multiple channels using laboratory-based procedures. Finally, it presents preliminary data that suggest that the safeguards taken to protect children were successful in making both children and their parents feel well treated and comfortable. (shrink)

Suicidal men feel the need to be self-reliant and that they cannot find another way out of relationship or socioeconomic issues. Suicide prevention is of crucial importance worldwide. The much higher rate of suicide in men engenders action. The prelude is a subjective experience that can be very isolating and severely distressing. Men may not realize a change in their thinking and behaviors, which makes it more difficult to seek and get help, thereby interrupting a “downward spiral”. Stoicism often (...) prevents men from admitting to their personal struggle. The lack of “quality” connections and “non-tailored” therapies has led to a high number of men “walking out” on traditional clinical approaches. But there are complicated relationships in motivations and formative behaviors of suicide with regards to emotional state, psychiatric disorders, interpersonal life events and suicidal behavior method selection. Middle-aged and older men have alternated as the most at-risk of suicide. There is no one solution that applies to all men, but digital tools may be of assistance. Digital interventions require higher levels of effectiveness for distress and suicidality but self-guided approaches may be the most suitable for men especially where linked with an integrated online suicide prevention platform. Furthermore, technology-enabled models of care offer promise to advance appropriate linking to mental health services through better and faster understanding of the specific needs of individuals and the type and level of suicidality experienced. Long-term evidence for suicidality and its evaluation may benefit from progressing human computer-interaction and providing impetus for an eminent integrated digital platform. (shrink)

This purpose of this qualitative study was to gather detailed information about student perceptions of self-plagiarism and the perceived effectiveness of a brief self-plagiarism video tutorial. Semi-structured interviews were conducted and health sciences doctoral students were queried regarding their knowledge and perceptions of self- plagiarism. The population for this study was new doctoral students, as well as students who had committed self-plagiarism during the semester. Overall, participants reported a specific self-plagiarism intervention was more helpful in (...) preventing self- plagiarism than a traditional plagiarism intervention and that the intervention should be included in initial program orientation. Overwhelmingly, students did not believe self- plagiarism was a serious academic offense and think they own their intellectual property and unpublished works. (shrink)

In the metaphor of behavioral momentum, the rate of a free operant in the presence of a discriminative stimulus is analogous to the velocity of a moving body, and resistance to change measures an aspect of behavior that is analogous to its inertial mass. An extension of the metaphor suggests that preference measures an analog to the gravitational mass of that body. The independent functions relating resistance to change and preference to the conditions of reinforcement may be construed as convergent (...) measures of a single construct, analogous to physical mass, that represents the effects of a history of exposure to the signaled conditions of reinforcement and that unifies the traditionally separate notions of the strength of learning and the value of incentives. Research guided by the momentum metaphor encompasses the effects of reinforcement on response rate, resistance to change, and preference and has implications for clinical interventions, drug addiction, and self-control. In addition, its principles can be seen as a modern, quantitative version of Thorndike's (1911) Law of Effect, providing a new perspective on some of the challenges to his postulation of strengthening by reinforcement. Key Words: behavioral momentum; clinical interventions; drug addiction; preference; reinforcement; resistance to change; response strength; self-control. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way (...) for sharing these insights and challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

This article reevaluates the Iranian polymath Ali Shariati’s most controversial lectures. Scholarly consensus reads 1969’s Ummat va Imāmat as derivative, comprising an imitation of Sukarno’s guided democracy and hence an apology for postcolonial authoritarian rule. Shariati’s rhetorical performance suggests otherwise. The lectures address a postcolonial iteration of Jean-Jacques Rousseau’s paradox of founding—a call for self-determination alongside the external intervention needed to prepare for it in the wake of moral dispositions accrued during colonization. Shariati proposes to resolve the problem (...) of enduring colonial domination by citing a fabricated French professor, a foreigner, as an authoritative source. He practices a noble lie, believable because it draws from colonized sensibilities but laden with hints encouraging audiences to see past it. If audiences develop the requisite ability to decipher the lie, Shariati wagers, they at once develop the autonomy implied by self-determination. On these grounds, Shariati theorizes the paradox of politics as decolonization. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

Kemalism has been the guiding and justifying ideology of the Turkish Republic since its institution in 1923. That Kemalism is exclusive to Turkey is a mainstay of Kemalist self-perception. But was (or is) Kemalism as political practice pursued by other regimes in the region? This paper argues that Kemalism should also be understood as a project of urbanism, and that urban interventions into Ankara, Tehran and Baghdad in the 20th century transformed all three into Kemalist cities. To illustrate, (...) I describe certain features of their spatial, symbolic and sensory re-organization. My concluding remarks address the radically divergent fate of Kemalist urbanism in the contemporary cities of Baghdad, Tehran and Ankara. (shrink)

This article addresses the use of computer-assisted career guidance systems (CACGS) in career interventions. Major CACGS developed in the past decades were based on the trait-factor or person-environment fit approaches in their conceptualization and design. The strengths and limitations of these CACGS in addressing the career development needs of individuals are discussed. The Career Construction Theory (CCT) is a promising paradigm to guide the development of new generations of CACGS. The narrative tradition, career adaptability model, and life-design interventions (...) of CCT offer rich conceptual and practical applications that could expand the scope and breadth of career exploration and identity construction through using CACGS. A digital system developed in Hong Kong called Infinity is a case-in-point of a CACGS where users could learn about career planning, engage in self and career construction through using the quantitative and qualitative assessment applications and gamified tools, take career planning actions over time, and communicate with their social supportive systems. Initial findings suggested that users of the system reported lesser decision-making difficulties, higher levels of decision clarity, and better understanding of what is career planning than non-users. Users from high academic achievement schools reported higher levels of career adaptability than their counterparts in schools of similar academic background. Users from low achievement schools reported higher intention to pursue government-supported universities than non-users from schools of similar background. Research and practice implications in schools and organizational settings are discussed. (shrink)

Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments. DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system. Trial RegistrationISRCTN89993391. (shrink)

Handwriting is a complex activity that involves continuous interaction between lower-level handwriting and motor skills and higher-order cognitive processes. It is important to allocate mental resources to these high-order processes since these processes place a great demand on cognitive capacity. This is possible when lower-level skills such as transcription are effortlessness and fluent. Given that fluency is a value in virtually all areas of academic learning, schools should provide instructional activities to promote writing fluency from the first stages of learning (...) to write. In an effort to determine if teaching handwriting enhances writing fluency, we conducted a systematic and meta-analytic review of the writing fluency intervention literature. We selected 31 studies: 21 true and quasi-experimental studies, 4 single-group design, 3 single-subject design, and 3 non-experimental studies, conducted with K-6 students in a regular school setting. A total of 2,030 students participated in these studies. When compared to no instruction or non-handwriting instructional conditions, teaching different handwriting intervention programs resulted in statistically significant greater writing fluency (ES = 0.64). Moreover, three specific handwriting interventions yielded statistically significant results in improving writing fluency, when compared to other handwriting interventions or to typical handwriting instruction conditions: handwriting focused on training timed transcription skills (ES = 0.49), multicomponent handwriting treatments (ES = 0.40), and performance feedback (ES = 0.36). There were not enough data to calculate the impact of sensory-motor and self-regulated strategy handwriting interventions on writing fluency. The significance of these findings for implementing and differentiating handwriting fluency instruction and guiding future research will be discussed. (shrink)

The world relies on authentic research that guides legislation, policy formulations, and governmental and corporate actions. Therefore, researchers globally should be aware of academic integrity and publication ethics. This research delved into plagiarism that severely undermines any scientific study. It explores the relationship between adverse attitudes (attitudes that favor plagiarism) and plagiaristic behavior. We probed deeper into the theories of planned behavior, reasoned action, and ethical theories of rational self-interest, cultural acceptance, and deontology to propose corrective measures as an (...) intervention to reduce adverse attitudes and plagiaristic behavior. Upon empirical testing of the said propositions through two studies (Study 1, n1 = 2609; Study 2, n2 = 2678), we ascertained a significant negative relationship between corrective measures and adverse attitudes and corrective measures and plagiaristic behavior. We also empirically examined the mediating effect of adverse attitudes on the relationship between corrective measures and plagiaristic behavior. The results confirm the mediation model, in which academics subjected to corrective actions reported reduced plagiaristic behavior through reduced adverse attitudes. The findings further the literature on plagiarism and provide crucial implications for managing plagiaristic behavior among academics. The study also provides specific corrective actions that educational administrators should initiate to ensure academic integrity. (shrink)

. The ability to enforce the provisions of a code of conduct influences whether the code is effective in shaping behavior. Enforcement relies in part on the willingness of organization members to report violations of the code, but research from the business and educational environment suggests that fewer than half of those who observe code violations follow their organizations procedures for reporting them. Based on a review of the literature in the business and educational environments, and a survey of 3605 (...) students at a mid-sized comprehensive university, this paper attempts to make conceptual sense of the non-reporting phenomenon. We present a conceptual framework based on four distinct factors which we have labeled: (1) factual non-responsibility; (2) moral non-responsibility; (3) consequential exoneration; and, (4) functional exoneration. Each of these factors suggest a different remedial strategy as well as provide a theoretical foundation for future research. Testable propositions for future research are developed, and some implications for organization leaders are discussed. (shrink)

We thank the commentators for their thoughtful responses to our article.1 Due to space constraints, we will confine our discussion to just three key issues. The first issue relates to the central ethical conundrum for clinicians working with young people like Phoenix: namely, how to respect, value and defer to a person’s own account of their identity and what is needed for their well-being, while staying open to the possibility that such an account may reflect a work in progress. This (...) conundrum thus relates both to what will be beneficial for that person and what constitutes respecting their autonomy, and clinicians must dwell on these questions when deciding what forms of medical intervention to offer. D’Angelo,2 Lemma3 and Wren4 highlight the importance of considering Phoenix (or, indeed, any person pursuing gender-affirming interventions) as a ‘whole person in context’ (p5)2 prior to initiating treatment or care. In this way, they advocate for a process of ‘therapeutic exploration’ (p1),4 which includes taking sufficient time to explore Phoenix’s personhood with them so as to support them in achieving an ‘authentic self-discovery’ (p5).2 We agree with these authors that identity (including gender identity) development is a complex, life-long process that is influenced by biological, psychosocial and relational aspects, all of which may contribute to an individual’s desire to pursue gender-affirming interventions. To explore the various factors—both conscious and unconscious—that might be motivating Phoenix’s decision to pursue ongoing puberty suppression (OPS), D’Angelo,2 Lemma3 and Wren4 describe a comprehensive psychological approach to working with transgender (trans) and gender diverse (TGD) individuals and propose questions to guide such discussions. Consistent with this approach, we stipulated that Phoenix had undergone regular psychological counselling and that the psychologist had judged that ‘Phoenix’s distress is significant and enduring…not a symptom …. (shrink)

Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder. The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce the (...) health impact even after the pandemic has already finished.Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID follows the principles of User Experience and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions.Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5–2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers.Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials. The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media. (shrink)

Recent developments in biotechnology and genetic research are raising complex ethical questions concerning the legitimate scope and limits of genetic intervention. As we begin to contemplate the possibility of intervening in the human genome to prevent diseases, we cannot help but feel that the human species might soon be able to take its biological evolution in its own hands. 'Playing God' is the metaphor commonly used for this self-transformation of the species, which, it seems, might soon be within our (...) grasp. In this important new book, Jurgen Habermas - the most influential philosopher and social thinker in Germany today - takes up the question of genetic engineering and its ethical implications and subjects it to careful philosophical scrutiny. His analysis is guided by the view that genetic manipulation is bound up with the identity and self-understanding of the species. We cannot rule out the possibility that knowledge of one's own hereditary factors may prove to be restrictive for the choice of an individual's way of life and may undermine the symmetrical relations between free and equal human beings. In the concluding chapter - which was delivered as a lecture on receiving the Peace Prize of the German Book Trade for 2001 - Habermas broadens the discussion to examine the tension between science and religion in the modern world, a tension which exploded, with such tragic violence, on September 11th. (shrink)

HARWOOD L and CLARK AM. Nursing Inquiry 2012; 19: 29–38 Understanding health decisions using critical realism: home‐dialysis decision‐making during chronic kidney diseaseThis paper examines home‐dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self‐management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home‐dialysis has clear health, societal and economic benefits yet service usage is (...) low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home‐dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re‐conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. (shrink)

Introducción: El examen estatal escrito evalúa la competencia del egresado y debe cumplir los requisitos de su confección y de su análisis informar las deficiencias en el proceso docente educativo para su perfeccionamiento. Objetivo: Caracterizar el examen estatal ordinario escrito y los resultados obtenidos en la Facultad de Estomatología. Camagüey durante el período 2011-2012. Métodos: Se realizó un estudio descriptivo del examen estatal ordinario escrito aplicado a 146 estudiantes. Se elaboró una base de datos con las calificaciones obtenidas, índice académico (...) y una guía con las variables tipo de examen, de preguntas, nivel de asimilación, claridad de formulación, correspondencia con los objetivos de la carrera, clave de calificación y cumplimiento de los criterios de Guilbert, analizados por grupo de expertos. Resultados: En los resultados se aproximó la nota de los excelentes (27,4 %) con el índice académico de los altos rendimientos (28,1 %). La mediana general fue de 86,3. Los temas más explorados fueron Endodoncia (18,8 %), Prótesis y Odontopediatría (10,4 %). Las preguntas con más valor fueron de temas curativos. El nivel de asimilación fue reproductivo y el 35,4 % de preguntas tipo selección múltiple complemento agrupado. Existieron dificultades de diseño del examen y autopreparación de los estudiantes. Conclusiones: Los resultados se aproximaron a los rendimientos académicos. No hubo equidad entre el número, valor de las preguntas por temas y nivel de asimilación. Los errores se asociaron en frecuencia al diseño y redacción de algunas preguntas, insuficiente estudio y en menor grado a la falta de sistematicidad en el proceso docente, que permitieron determinar las deficiencias para su intervención. Introduction: The State written exam evaluates the competence of seniors and must meet the requirements of its preparation and analysis in order to report deficiencies in the educational teaching process for its further development. Objective: To characterize the written regular state exam and the results obtained at the Faculty of Stomatology. Camaguey during the period of 2011-2012. Methods: A descriptive study of the written regular state exam was conducted to 146 students. A data base was developed with the grades obtained, academic index and a guide with the exam- type variables, questions, level of assimilation, clarity of formulation, correspondence with the objectives of the career, key qualification and compliance with the criteria of Guilbert, all analyzed by groups of experts. Results: In the results the excellent notes (27.4%) approached to the academic index of high yield (28.1%). The general average was 86,3. The most explored themes were Endodontics (18.8%), Prosthesis and Pediatric Odontology (10.4%). healing topics were the questions with more value. The level of assimilation was reproductive and 35.4% of multiple choice type questions complement clustered. There were difficulties according to the test design and the students' self study. Conclusions: The results were close to academic performance. There was no equality between the number, value of the questions by topic and level of assimilation. Errors were often associated with the design and wording of some questions, insufficient study and in a lesser extent to the lack of systematic fashion in the teaching process, which allowed to determine deficiencies for its intervention. (shrink)