Background: COVID-19 pandemic has led to heightened moral distress among healthcare providers. Despite evidence of gendered differences in experiences, there is limited feminist analysis of moral distress. Objectives: To identify types of moral distress among women healthcare providers during the COVID-19 pandemic; to explore how feminist political economy might be integrated into the study of moral distress. Research Design: This research draws on interviews and focus groups, the transcripts of which were analyzed using framework analysis. Research Participants and Context: 88 (...) healthcare providers, based in British Columbia Canada, participated virtually. Ethical Considerations: The study received ethical approval from Simon Fraser University. Findings: Healthcare providers experienced moral dilemmas related to ability to provide quality and compassionate care while maintaining COVID-19 protocols. Moral constraints were exacerbated by staffing shortages and lack of access to PPE. Moral conflicts emerged when women tried to engage decision-makers to improve care, and moral uncertainty resulted from lack of clear and consistent information. At home, women experienced moral constraints related to inability to support children’s education and wellbeing. Moral conflicts related to lack of flexible work environments and moral dilemmas developed between unpaid care responsibilities and COVID-19 risks. Women healthcare providers resisted moral residue and structural constraints by organizing for better working conditions, childcare, and access to PPE, engaging mental health support and drawing on professional pride. Discussion: COVID-19 has led to new and heightened experiences of moral distress among HCP in response to both paid and unpaid care work. While many of the experiences of moral distress at work were not explicitly gendered, implicit gender norms structured moral events. Women HCP had to take it upon themselves to organize, seek out resources, and resist moral residue. Conclusion: A feminist political economy lens illuminates how women healthcare providers faced and resisted a double layering of moral distress during the pandemic. (shrink)

Recent work in social psychology suggests that people harbor “implicit race biases,” biases which can be unconscious or uncontrollable. Because awareness and control have traditionally been deemed necessary for the ascription of moral responsibility, implicit biases present a unique challenge: do we pardon discrimination based on implicit biases because of its unintentional nature, or do we punish discrimination regardless of how it comes about? The present experiments investigated the impact such theories have upon moral judgments about racial discrimination. The results (...) show that different theories differ in their impact on moral judgments: when implicit biases are defined as unconscious, people hold the biased agent less morally responsible than when these biases are defined as automatic (i.e., difficult to control), or when no theory of implicit bias is provided. (shrink)

Academic programs in the medical/health humanities have proliferated widely in recent years, and the professional, academic, and cultural drivers of this growth promise sustained new program development. In this article, we present the results of a survey sent to representatives of one hundred twenty-four baccalaureate and ten graduate programs in the medical/health humanities to assess the experiences and needs of existing programs. Survey results confirm the interest in and need for a descriptive toolkit as opposed to a prescriptive manual; indicate (...) what data and materials are most needed to support the successful development of new academic programs in the field; and identify areas for future research. Recognizing a need for program development resources, the Health Humanities Consortium has initiated the creation of a comprehensive online toolkit. We discuss survey results and the toolkit in relation to the drivers of new program growth. Finally, we describe resources now available through the HHC’s new online program toolkit, including existing programs; sample syllabi; sample curricula templates; program rationale; proposal templates; and graduation data. (shrink)

Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption, involve uncertain and potentially high risk, with minimal chance of clinical benefit. Some question whether such trials should be offered, given the risk/benefit imbalance, and whether those who choose to participate are acting rationally. We address these questions through a longitudinal decision-making study (...) nested in a Thai acute HIV research cohort. In-depth interviews revealed central themes about decisions to join. Participants felt they possessed an important identity as members of the acute cohort, viewing their bodies as uniquely suited to both testing and potentially benefiting from HIV cure approaches. While acknowledging risks of ATI, most perceived they were given an opportunity to interrupt treatment, to test their own bodies and increase normalcy in a safe, highly monitored circumstance. They were motivated by potential benefits to themselves, the investigators and larger acute cohort, and others with HIV. They believed their own trial experiences and being able to give back to the community were sufficient to offset participation risks. These decisions were driven by the specific circumstances experienced by our participants. Judging risk/benefit ratios without appreciating these lived experiences can lead to false determinations of irrational decision- making. While this does not minimise vital oversight considerations about risk reduction and protection from harm, it argues for inclusion of a more participant-centered approach. (shrink)

O presente manuscrito apresenta relações de religiosidade e espiritualidade (R∕E) com diferentes indicadores sociais, educacionais e de saúde durante a Pandemia da COVID-19 no Brasil Particularmente, mostra que R∕E tem efeitos positivos nos indicadores de felicidade, bem-estar subjetivo, percepção de dor e nos diferentes índices de saúde mental. Conclui afirmando que a dimensão religiosidade e espiritualidade tem múltiplas facetas, embora seja ainda negligenciada no ensino e na pesquisa em saúde pública, especialmente em saúde mental.

A escola é um espaço importantíssimo para o desenvolvimento de trabalhos e ações que envolvem a gestão de resíduos sólidos, tema cada vez mais discutido em trabalhos e eventos científicos. Com o objetivo de sensibilizar educandos para o problema, um grupo de bolsistas do Pibid Interdisciplinar – Educação ambiental realizou um experimento em que ações socioambientais foram propostas e desenvolvidas junto com educandos de uma escola parceira. As experiências vivenciadas no cotidiano escolar dos dois grupos tiveram como técnicas de coleta (...) de dados necessários à elaboração coletiva das ações, observações e oficinas teórico-práticas, em quatro encontros, nos quais o tema foi abordado teoricamente, através de exibição de documentários e realização de algumas dinâmicas. A ação resultante foi um trabalho de reciclagem com o reaproveitamento de materiais que seriam descartados, ao longo do qual ocorreram discussões que consistiam em uma problematização que, a partir da realidade dos alunos, tentava contribuir para que eles percebessem problemas ambientais presentes em seu dia a dia, convidando-os a refletir sobre os seus hábitos de consumo, a forma de descarte dos resíduos provenientes do seu ato de consumir e os prejuízos por eles causado na natureza. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first (...) semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

Dissociative experiences have been associated with diachronic disunity. Yet, this work is in its infancy. Dissociative identity disorder is characterized by different identity states reporting their own relatively continuous sense of self. The degree to which patients in dissociative identity states experience diachronic unity has not been empirically explored. This study examined the degree to which patients in dissociative identity states experienced diachronic unity. Participants were DID adults assessed in adult and child identity states, adults with a psychotic illness, adults (...) from the general population, children from the general population and adults imagining themselves as children. They completed the Diachronic Disunity Scale, the Dissociative Experiences Scale, and the Self-Concept Clarity Scale. Diachronic disunity was not limited to psychiatric groups, but evident to some degree in all adult and child samples. The DID adult sample experienced more dissociation and self-confusion than the psychosis and adult comparison groups, but did not differ on the diachronic measure. DID patients in their child identity states and child comparisons showed disunity and were significantly different from child simulators, who showed relatively more unity. Results suggest that DID patients in either adult or child dissociative identity states, like those in other samples, do not universally experience themselves as having a consistent sense of self over time. (shrink)

Guilt and shame are self-conscious emotions with implications for mental health, social and occupational functioning, and the effectiveness of sports practice. To date, the assessment and role of athlete-specific guilt and shame has been under-researched. Reporting data from 174 junior elite cricketers, the present study utilized exploratory factor analysis in validating the Athletic Perceptions of Performance Scale, assessing three distinct and statistically reliable factors: athletic shame-proneness, guilt-proneness, and no-concern. Conditional process analysis indicated that APPS shame-proneness mediated the relationship between general (...) and athlete-specific distress. While APPS domains of guilt-proneness and no-concern were not significant mediators, they exhibited correlations in the expected direction with indices of psychological distress and well-being. The APPS may assist coaches and support staff identify players who may benefit from targeted interventions to reduce the likelihood of experiencing shame-prone states. (shrink)

A feature is central to a concept to the extent that other features depend on it. Four studies tested the hypothesis that people will project a feature from a base concept to a target concept to the extent that they believe the feature is central to the two concepts. This centrality hypothesis implies that feature projection is guided by a principle that aims to maximize the structural commonality between base and target concepts. Participants were told that a category has two (...) or three novel features. One feature was the most central in that more properties depended on it. The extent to which the target shared the feature's dependencies was manipulated by varying the similarity of category pairs. Participants' ratings of the likelihood that each feature would hold in the target category support the centrality hypothesis with both natural kind and artifact categories and with both well-specified and vague dependency structures. (shrink)

When covering traumatic events, novice journalists frequently face situations they are rarely prepared to resolve. This paper highlights ethical dilemmas faced by journalists who participated in a focus group exploring the news media's trauma coverage. Major themes included professional obligations versus ethical responsibilities, journalists' perceived status and roles, permissible harms, and inexperience. Instructional classroom simulations based on experiential learning theory can bridge the gap between the theory of ethical trauma reporting and realities journalists face when covering events that are often (...) chaotic and unpredictable by their very nature. A simulation outline that can be used by journalism instructors is provided. (shrink)

The view that properties have their causal powers essentially, which I will here call property essentialism, has advocates in Chris Swoyer,[1] Sydney Shoemaker [2], Alan Chalmers [3], Brian Ellis [4] and Caroline Lierse [5], among a few other authors in recent literature. I am partial to this view as well and I will shortly explain the grounds I find compelling in favor of it. However, we will also see that the essentialist view of properties and laws does not adequately do (...) quite so much as might be hoped. Property essentialism has the straightforward result that at least causal laws are metaphysically necessary. A natural view of such laws is that they are analyses of the essential nature of basic properties in terms of their essential causal powers. Brian Ellis proposes that conservation laws and other laws that may not be exactly causal are best thought of as characterizing the essential properties of worlds. But this further essentialist thesis is not directly relevant to the issues I want to address here. (shrink)

Les livres qui proposent, en littérature, des lectures phénoménologiques et, en phénoménologie, des lectures littéraires, comme ceux qui, plus généralement en philosophie, engagent des phénoménologies de la littérature ou de l'œuvre littéraire sont aussi nombreux que ceux qui interrogent la phénoménologie et la littérature, ou la littérature et la phénoménologie. Ce volume, unique en son genre, a pris une option très spécifique, qui est une sorte de perspectivisme : interroger la position d'entre-deux du phénoménologue et, à travers lui en sa (...) fonction de 'décrivant', la posture de la phénoménologie entre - voire à l'intersection de - la philosophie et la littérature. À cette dimension concernant la matière et la méthode de la démarche, il s'en ajoute toutefois une autre : ce livre est le fruit d'une collaboration internationale, entre des phénoménologues belges, français et péruviens qui tous ont œuvré pour que la phénoménologie use de ses lettres de noblesse dans le champ des littératures. Et ils le font dans le cadre d'une démarche interdisciplinaire car ils sollicitent les apports des neurosciences, de l'herméneutique, des arts tels la peinture, le cinéma ou encore la poésie, mais aussi les enjeux de réflexion éthique. Avec ce volume, riche par sa diversité et par sa portée interculturelle, ce sont en trois universités qui portent un projet rigoureusement collaboratif : l'UC Louvain de Louvain-la-Neuve, en Belgique, l'Universidad del Pacífico et la Pontificia Universidad Católica del Perú de Lima, au Pérou. Par conséquent, il est aussi évident que ces rapports entre phénoménologie et littérature se disent linguistiquement au carrefour des cultures francophone, hispanophone et aussi anglophone."--Page 4 of cover. (shrink)

The rise of the concept of education to the leading category of modernity initially appears as a life-world equivalent to the settings of subject philosophy and concentrates on the expansion of one's own self- and world reference. With the problematization of subject-philosophical thinking, there are corresponding shifts in meaning in the concept of education: its changes can be understood as an examination of this origin. Based on the writings of Humboldt, Hegel and Novalis, Rosemarie Boenicke shows how responsiveness and reciprocity (...) are increasingly becoming an issue and how these shifts determine the current development of the concept of education. (shrink)

Culture is the most difficult thing about an organization to change in a lasting way. Our paper is predicated upon the idea that better ethics leadership through change is the foundation to more successful implementation of change. Ethical culture will enable the firm to initiate the change process from a stronger position: the obstacles to change such as mistrust, fear of uncertainty, failure of communication and empowerment will be easier to overcome in an atmosphere pursuing the ethically correct approach, combining (...) ethical leadership with an ethical corporate culture. Our idea goes one step beyond the virtuous change circle by incorporating a series of check points a leader can reference to stay on a course of change management based in good ethical principle that will lead to effective change. Our model incorporates the concept of values into the management of change; this allows for a more comprehensive approach to change management by the utilization of well-known change management principles used in conjunction with basic principles of ethics. We argue that the change leader can depend on this more comprehensive approach for a better assurance of ethical and therefore more effective change. Our idea also would be effective regardless of the type of change confronting the organization and/or the leaders of the firm. Our point is that, while change is by its nature hard and there is an inclination to resist change, with ethical change management, the firm has a better chance of success. (shrink)

Rosemary Hennessy confronts some of the impasses in materialist feminist work on rethinking `woman' as a discursively constructed subject. She argues for a theory of discourse as ideology taking into account the work of Kristeva, Foucault and Laclau.

Summary A number of elite boys? schools in England have admitted girls for over 30 years, some thereby becoming mixed schools. In other schools, girls remain a very small minority. This paper focuses upon prospectuses from the latter type of school, arguing that prospectuses are particularly valuable as a basis for judging schools? policies and practices in their own terms. The researchers ask questions about the nature of this form of ?co-education?, particularly as it affects girls? educational and social opportunities. (...) On balance, the prospectuses paint a picture of boys? schools which happen to have girls in them rather than of schools whose policies and practices have become genuinely co-educational. (shrink)

No other cluster of medical issues affects the genders as differently as those related to procreationcontraception, sterilization, abortion, artificial insemination, in-vitro fertilization, surrogate motherhood, and genetic screening. Rosemarie Tong s approach to feminist bioethics serves as a catalyst to bring together different feminist voices in hope of actually doing something to make gender equity a present reality rather than a mere future possibility.".

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and arts practices (...) in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

Medically unexplained symptoms (MUS) are common and costly in both primary and secondary health care. It is gradually being acknowledged that there needs to be a variety of interventions for patients with medically unexplained symptoms to meet the needs of different groups of patients with such chronic long-term symptoms. The proposed intervention described herewith is called The BodyMind Approach (TBMA) and promotes learning for self-management through establishing a dynamic and continuous process of emotional self-regulation. The problem is the mismatch between (...) the patient’s mind-set and profile and current interventions. This theoretical article, based on practice-based evidence, takes forward the idea that different approaches (other than cognitive behaviour therapy) are required for people with MUS. The mind-set and characteristics of patents with MUS are reflected upon to shape the rationale and design of this novel approach. Improving services for this population in primary care is crucial to prevent the iterative spiralling downwards of frequent GP visits, hospital appointments, and Accident and Emergency attendance, all of which are common for these patients. The approach derives from embodied psychotherapy (authentic movement in dance movement psychotherapy) and adult models of learning for self-management. It has been developed from research and practice-based evidence. In this article the problem of MUS in primary care is introduced and the importance of the reluctance of patients to accept a psychological/mental health referral in the first instance is drawn out. A description of the theoretical underpinnings and philosophy of the proposed alternative to current interventions is then presented related to the design, delivery, facilitation and educational content of the programme. The unique intervention is also described to give the reader a flavour. (shrink)

"Künstlerische Selbstverletzung - seit den 1960er Jahren international fester Bestandteil der Performance Art - polarisiert, verstört und wirft vor allem Fragen nach Handlungsmotivationen auf. Rosemarie Brucher deutet dieses radikale Phänomen als Bewältigungsversuch bedrohter Autonomie und damit in erster Linie als Ermächtigungsstrategie. In dieser Ambivalenz aus Subjektermächtigung und Naturunterwerfung lässt sich künstlerische Selbstverletzung vor dem Hintergrund von Immanuel Kants Ästhetik des Erhabenen lesen, was die Autorin exemplarisch an VALIE EXPORT und Stelarc darlegt. Eine solche Bezugsetzung eröffnet nicht nur einen innovativen Zugang (...) zu dieser Kunstform, sondern wirft zugleich auch ein neues Licht auf Kants Erhabenheitskonzeption"--Back cover. (shrink)

Dying and creating or, could we put it the other way round, creating and dying? Rosemary Gordon has chosen the first, the challenging title and the one that stimulates the reader to find out how they inter-relate. There are essential links between the facts and the concepts. C. G. Jung devoted much attention to the psychology of death, re-birth and transformation: the author acknowledges her debt to him, to his creative spirit and to the depth of his understanding. As (...) she is a working analytical psychologist, much of the material in her. But she is also a theorist: the human and the academic come together.Many Westerners in the course of their daily lives conceal their fears of death and so they deprive themselves of the possibility of getting into touch with the hidden sources of creativeness. Patients in analysis communicate some of their deepest feelings and thoughts about preparing for death, and grieving, and dying. (shrink)

We investigate how the perceived uncertainty of a conditional affects a person's choice of conclusion. We use a novel procedure to introduce uncertainty by manipulating the conditional probability of the consequent given the antecedent. In Experiment 1, we show first that subjects reduce their choice of valid conclusions when a conditional is followed by an additional premise that makes the major premise uncertain. In this we replicate Byrne. These subjects choose, instead, a qualified conclusion expressing uncertainty. If subjects are given (...) a third statement that qualifies the likelihood of the additional premise, then the uncertainty of the conclusions they choose is systematically related to the suggested uncertainty. Experiment 2 confirms these observations in problems that omit the additional premise and qualify the first premise directly. Experiment 3 shows that the qualifying statement also affects the perceived probability of the consequent given the antecedent of the conditional. Experiment 4 investigates the effect of suggested uncertainty on the fallacies and shows that increases in uncertainty reduce the number of certain conclusions that are chosen while affirming the consequent but have no effect on denying the antecedent. We discuss our results in terms of rule theories and mental models and conclude that the latter give the most natural account of our results. (shrink)

Four experiments investigated uncertainty about a premise in a deductive argument as a function of the expertise of the speaker and of the conversational context. The procedure mimicked everyday reasoning in that participants were not told that the premises were to be treated as certain. The results showed that the perceived likelihood of a conclusion was greater when the major or the minor premise was uttered by an expert rather than a novice (Experiment 1). The results also showed that uncertainty (...) about the conclusion was higher when the major premise was uttered by a novice and an alternative premise by an expert, compared to when the major premise was uttered by an expert and the alternative by a novice (Experiment 2). Similarly, the believability of a conclusion was considerably lower when the minor premise was uttered by a novice and denied by an expert, as opposed to when an expert uttered the minor premise and a novice denied it (Experiment 3). Experiment 4 showed that the nature of the uncertainty induced by a denial of the minor premise depended on whether or not the context was a conversation. These results pose difficult problems for current theories of reasoning, as current theories are based on the results of experiments in which the premises are treated as certain. Our discussion of the results emphasises the importance of pragmatics in reasoning, namely, the role of general knowledge about the world in assessing the probability of a premise uttered by an expert or a novice and the role of interpretations of the premise based on pragmatic inferences in revising these initial probabilities. (shrink)

In this paper I seek to distinguish a feminist virtue ethics of care from (1) justice ethics, (2) narrative ethics, (3) care ethics and (4) virtue ethics. I also connect this contemporary discussion of what makes a virtue ethics of care feminist to eighteenth and nineteenth century debates about male, female, and human virtue. I conclude that by focusing on issues related to gender - primarily those related to the systems, structures, and ideologies that create and sustain patterns of male (...) domination and female subordination - we can begin to appreciate that true care and bona-fide virtue can flourish only in societies that treat all persons with equal respect and consideration. (shrink)

1. IntroductionA paternalistic act is one in which the protection or promotion of a subject's welfare is the primary reason for attempted or successful coercive interference with an action or state of that person. My aim in this paper is to determine the conditions under which such acts are Justified. The route I take is through the concept of consent, with actual consent providing the foundation for a rather complex condition which I claim is necessary and sufficient for the Justification (...) of paternalism.Because a paternalistic act apparently violates a subject's right to non-interference, it constitutes a problem in the general area of rights. Ideally, then, one should have a developed and convincing theory of rights — that is, a theory which contains an analysis of the concept of a right, and offers solutions to the central problems, e.g. who has rights and why, what considerations override prima facie rights, and how the relative importance of prima facie rights is determined — from which the solutions to various problems about paternalism can be derived. (shrink)

Even today entering Neapolis, modern day Kavala, in Greece it is possible to imagine Paul stepping off a ship onto the landing. This is the craft of the author of Luke's Gospel and the Acts of the Apostle to engage the hearer in the narrative he constructs: in Acts, the birth and mission of the church is a story in which the audience have a role. According to Acts, Paul followed a vision, a call from a certain Macedonian to 'Come (...) over to Macedonia and help us'. What would he have expected to find as he set out on a sea voyage from Asia to Macedonia, the home of Alexander the Great? Paul's landing is commemorated on a wall mosaic with ancient stone bollards and pillars slightly inland from the current promenade where the fishing boats line up around the bay. Paul's embarkation on this journey has all the hallmarks of mission. His journey will take him to Philippi and beyond. The focus here is particularly on his encounter with Lydia and the flourishing of this mission in a distinct and different place with new opportunities for the development and growth of leadership and community. In particular I will concentrate on the insights of this narrative for the engagement with new frontiers in our present day. (shrink)

The outcomes of psychoanalysis, as with other psychotherapies, vary considerably. _Psychoanalytic Treatment in Adults _examines the results of a longitudinal study of change during psychoanalysis, illuminating the characteristics of patients, analysts and analyses which can help to predict outcomes of treatment. Written by experienced psychologists and psychoanalysts, chapters in the book draw upon sixty case studies to consider how patients with very different analytic outcomes respond at both the beginning and end of their analysis. Psychoanalysts used a clinician report measure, (...) the Shedler-Westen Assessment Procedure, to describe a patient at the beginning of psychoanalysis and every six months until the analysis ended. This allowed the authors to learn about changes over analysis and, in turn, improved treatment planning and practice for the well-being of other patients. Chapters explore five outcomes: a negative therapeutic reaction; attrition when the patient drops out; attrition due to external events; mutual agreement between patient and analyst without maximum benefits; and mutual agreement between patient and analyst with maximum benefits. The findings from these chapters will be of interest to researchers and academics in the fields of psychoanalysis, psychotherapy, psychodynamic therapy, psychoanalytic education, psychiatry and psychology. The results should also help clinicians recognize potential problems early in analytic treatments so that they can work more effectively with patients. (shrink)