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- Go to article: Who Am I to Treat This Person? What It Feels Like to Treat a Seriously Disturbed Patient
Who am I to treat this person? That is what came to mind every time I treated a seriously disturbed patient. I do not know enough, and I have hang-ups. But no one knows enough, and every therapist has hang-ups, although our own analysis helps. We may feel confused, frightened, angry, or hopeless because these are the patient’s feelings. Discussed are creating rational hope, dealing with feelings (including terror), depression, delusions, hallucinations, and suicidal and homicidal dangers. Theory is helpful, but it is not enough. Tolerating not knowing often leads to effective improvisations. Best results were obtained with psychoanalysis or psychoanalytic therapy without medication. Next best was psychoanalytic therapy with initial medication withdrawn as rapidly as the patient can tolerate. Electroconvulsive therapy is discouraged.
- Go to article: Brave New Psychiatry and the Idealization of Nonplaces: A Critical Discourse Analysis
In this article, a document presenting a planned psychiatric building in Sweden was analyzed using critical discourse analysis. Focus was on how biomedical perspectives, administration, logistics, and efficiency is materialized in the building. The building is planned without personal consulting rooms or office places. Text and images were understood with reference to Augé's concept of nonplaces; places that are void of meaning. Outpatient practice is portrayed as equal, neglecting power imbalances, diversity, and context. Clinicians and clients are expected to be in transit in an environment centered on transparency and technology, enabling surveillance and control. Encounters and dialogues are never mentioned, while electroconvulsive therapy has its own place both in the document and in the building. Technology is central and presented as necessary for future needs. The idea that current psychiatry represents a story of constant progress, providing precise diagnosis and effective treatment is materialized in the building.
Persuasive design, the use of behavioral psychology in digital devices and applications to alter human behavior, is employed in entertainment and educational technologies that occupy a great proportion of the lives of children and adolescents. A primary purpose of persuasive design is to increase the time spent using social media, video game, and other entertainment technologies in order to increase business revenue. This adds to children's and adolescents' health risks, as excessive recreational screen time has been associated with both physical (sleep, weight) and mental health (depression, anxiety, compulsive use, and inattention) issues for children and adolescents. Given the potential for negative health outcomes, it is necessary for the field of psychology to acknowledge, educate, and take action against the use of persuasive design in platforms typically used by children and adolescents.
- Go to article: Perception of Ethical Issues Among the Law Enforcement and Firefighter Psychologists From Romania
Ethical psychological practice is essential for beneficiaries’ protection and welfare. This survey research addressed a specific issue, namely compliance with and beliefs about ethical principles and standards of psychologists from the Romanian national law enforcement and firefighting organizations. A total of 140 psychologists, 60.08% of target group members, rated frequency and ethical character of 139 ethically questionable behaviors. Several positive ethical elements were found as lack of almost universal behaviors and many rare behaviors (46.04%). Among the ethical problems found were counted: behaviors and beliefs related to the involvement in ethical practice promotion among psychologists and to the interaction with coordinating and homologous psychologists in the professional or ethical impasse situations. The highest quality ratings of resources for ethical practice guiding and training were made for Code of Deontology and the lowest for legal cases. Several solutions were proposed to improve ethical professional awareness and practice of target group members. The present research showed the difficulty of finding benchmarks to interpret results of an ethical research and the need to approach ethical issues not only from the quantitative view but also from qualitative and/or transcultural view.
Antidepressant drugs are the mainstay of depression treatment in both primary and specialized mental health care. However, academic psychiatry holds false beliefs about antidepressants and we expose two of them in this essay. First, recent attitude surveys conducted among psychiatrists and general practitioners have revealed that physicians attribute antidepressants’ effects mostly to the drugs’ pharmacologic action and less so to placebo effects. Second, academic psychiatry maintains that physical dependence to antidepressant drugs does not exist and that “discontinuation symptoms” upon stopping maintenance pharmacotherapy are benign and affect only a small minority of antidepressant users. As we review in this essay, these beliefs are at odds with the scientific literature. The largest and most comprehensive meta-analysis of antidepressant trials conducted to date indicates that 88% of the drugs’ treatment outcome is accounted for by placebo effect. Furthermore, physical dependence appears to be a serious issue, as severe and persistent withdrawal reactions affect up to 50% of antidepressant users according to several studies. Correcting false beliefs prevailing in academic psychiatry is needed and has important implications for psychiatric training, continuing medical education, and practice.