Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders. However, researchers have yet to compare novice ratings on the AMPD’s Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure. We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels (...) of reliability to that of an expert rater using the crucible of the classical case of “Madeline G.” Examination of AMPD and SWAP ratings of “Madeline G.” revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment. (shrink)

An estimated 14 million children are parented by gay or lesbian couples. Research indicates that children of same-sex parents are as well adjusted as their peers of opposite-sex parents. However, previous research has yet to examine how these youth negotiate their own process of coming out about their families to others. We sought to identify the patterns, issues and themes that recur in the coming out process of these youth. Recommendations for school personnel are described.

ObjectiveStudies that examine disordered eating in samples of Asian individuals living in the United States frequently combine all individuals of Asian descent into a single group, which can obscure important differences between groups and their experiences of acculturation. The goal of the present study was to establish the relation of acculturation, internalization of appearance ideals, and religiosity as predicting body dissatisfaction and disordered eating in women of South and Southeast Asian descent.MethodWomen of SSEA descent aged 18–51 years completed a battery (...) of questionnaires that inquire about these variables. A path analysis was conducted with acculturation serving as the independent variable, religiosity and internalization of the thin ideal as mediators, and body dissatisfaction and disordered eating as dependent variables.ResultsDirect paths from acculturation to both body dissatisfaction and disordered eating were not significant. Thin ideal internalization completely accounted for the path from acculturation to both endogenous variables; whereas, religiosity did not significantly account for any indirect effect.DiscussionFor SSEA women, internalization of appearance ideals is a potentially greater risk factor for disordered eating than acculturation or religiosity. As this was an atemporal mediation analysis, more work needs to be done exploring predictors of internalization in this population and how that may impact the development of disordered eating. (shrink)

BackgroundClinical ethics support aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization.MethodsThis integrative approach was developed in an iterative process, combining actual experiences in a case study (...) in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences.ResultsIn this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design.ConclusionsIn the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES. (shrink)

Edwin Hartman argues that ethical principles should not derive from abstract theory, but from the real world of experience in organizations. He explains how ethical principles derive from what workers learn in their communities (firms), and that an ethical firm is one that creates the good life for the workers who contribute to its mission. His approach is based on the Aristotelian tradition of refined common sense, from recent work on collective action problems in organizations, and from social contract (...) theory. (shrink)

In this, the first Reader of Geoffrey Hartman's work, significant essays reflect his abiding interest in English and American poetry, focusing not only on Romanticism but also on the transition from early modern to modern and including reflections on the radical elements in artistic representation.

The virtue approach to business ethics is a topic of increasing importance within the business world. Focusing on Aristotle's theory that the virtues of character, rather than actions, are central to ethics, Edwin M. Hartman introduces readers of this book to the value of applying Aristotle's virtue approach to business. Using numerous real-world examples, he argues that business leaders have good reason to take character seriously when explaining and evaluating individuals in organisations. He demonstrates how the virtue approach can (...) deepen our understanding of business ethics, and how it can contribute to contemporary discussions of character, rationality, corporate culture, ethics education and global ethics. Written by one of the foremost Aristotelian scholars working in the field today, this authoritative introduction to the role of virtue ethics in business is a valuable primer for graduate students and academic researchers in business ethics, applied ethics and philosophy. (shrink)

Chemistry educator Alex H. Johnstone is perhaps best known for his insight that chemistry is best explained using macroscopic, submicroscopic, and symbolic perspectives. But in his writings, he stressed a broader thesis, namely that teaching should be guided by scientific research on how the brain learns: cognitive science. Since Johnstone’s retirement, science’s understanding of learning has progressed rapidly. A surprising discovery has been when solving chemistry problems of any complexity, reasoning does not work: students must apply very-well-memorized facts and algorithms. (...) Following Johnstone’s advice, we review recent discoveries of cognitive science research. Instructional strategies are recommended that cognitive studies have shown help students learn chemistry. (shrink)

There is a contradiction in our ideas about moral responsibility. In one strand of our thinking, we believe that a person can become more blameworthy by luck. Consider some examples in order to make that idea concrete. Two reckless drivers manage their vehicles in the same way, and one but not the other kills a pedestrian. Two corrupt judges would each freely take a bribe if one were offered. By luck of the courthouse draw, only one judge is offered a (...) bribe, and so only one takes a bribe. Luck is the salient difference between the agents in each case. After all, the spatial location of the pedestrian is outside of each driver’s control, and being offered a bribe is outside of each judge’s control. But we blame the killer driver more than the merely reckless driver, and we blame the bribe-taker more than the mere would-be bribe-taker. This is because we believe that the killer driver and the bribe-taker are more blameworthy than each of their counterparts. Nevertheless, the idea that luck affects moral responsibility contradicts another feature of our thinking captured in this moral principle: A person’s blameworthiness cannot be affected by that which is not within her control. This moral principle yields the verdict that the drivers are equally blameworthy and that the judges are equally blameworthy. So, to put the contradiction in concrete terms, our thinking about moral responsibility implies that the drivers are and are not equally blameworthy, and the same is true for the judges. -/- I argue that only the first strand of our thinking is correct. Certain kinds of luck in results, circumstances, and character can partially determine a person’s praiseworthiness and blameworthiness. In terms of the examples, I argue that the killer driver and the bribe-taker are more blameworthy than each of their counterparts. But if I am to make genuine progress in the moral luck debate, my arguments cannot appeal to case intuitions such as ‘the killer driver is more blameworthy,’ because the problem of moral luck is fundamentally a clash of intuitions. So, I offer arguments from diverse areas in philosophy in order to ensure that they do not bottom out in standard pro-moral luck intuitions. (shrink)

The prevalence of Clinical ethics support services is increasing. Yet, questions about what quality of CES entails and how to foster the quality of CES remain. This paper describes the development of a national network, which aimed to conceptualize and foster the quality of CES in the Netherlands simultaneously. Our methodology was inspired by a responsive evaluation approach which shares some of our key theoretical presuppositions of CES. A responsive evaluation methodology engages stakeholders in developing quality standards of a certain (...) practice, instead of evaluating a practice by predefined standards. In this paper, we describe the relationship between our theoretical viewpoint on CES and a responsive evaluation methodology. Then we describe the development of the network and focus on three activities that exemplify our approach. In the discussion, we reflect on the similarities and differences between our approach and other international initiatives focusing on the quality of CES. (shrink)

Galen Strawson’s Basic Argument is that because self-creation is required to be truly morally responsible and self-creation is impossible, it is impossible to be truly morally responsible for anything. I contend that the Basic Argument is unpersuasive and unsound. First, I argue that the moral luck debate shows that the self-creation requirement appears to be contradicted and supported by various parts of our commonsense ideas about moral responsibility, and that this ambivalence undermines the only reason that Strawson gives for the (...) self-creation requirement. Second, I argue that the self-creation requirement is so demanding that either it is an implausible requirement for a species of true moral responsibility that we take ourselves to have or it is a plausible requirement of a species of true moral responsibility that we have never taken ourselves to have. Third, I explain that Strawson overgeneralizes from instances of constitutive luck that obviously undermine moral responsibility to all kinds of constitutive luck. (shrink)

It may be nearly impossible to use standard principles to make a decision about a complex ethical case. The best decision, say virtue ethicists in the Aristotelian tradition, is often one that is made by a person of good character who knows the salient facts of the case and can frame the situation appropriately. In this respect ethical decisions and strategic decisions are similar. Rationality plays a role in good ethical decision-making, but virtue ethicists emphasize the importance of intuitions and (...) emotions as well.Virtue ethics suggests a reconciliation of the factual and the normative. Virtues may explain as well as justify actions. The same is true of other psychological states and events. That psychological terms have normative implications does not render them useless in explanation. As Aristotle does not distinguish cleanly between the normative and empirical, so many moral philosophers today reject the is-ought dichotomy. They are prepared to learn from economists, psychologists, and other empirical scientists who offer information about the nature of the good life and of values. Social psychologists who study community or corporate culture suggest a close relationship between organizational and ethical features, much as Aristotle saw a close relationship between politics and ethics. We should infer from all this that in business ethics there is good reason for philosophers and organization scholars to work closely together. (shrink)

It is conventional wisdom that appreciating the role of luck in our moral lives should make us more sparing with blame. But views of moral responsibility that allow luck to augment a person’s blameworthiness are in tension with this wisdom. I resolve this tension: our common moral luck partially generates a duty to forgo retributively blaming the blameworthy person at least sometimes. So, although luck can amplify the blame that a person deserves, luck also partially generates a duty not to (...) give the blameworthy person the retributive blame that he deserves at least sometimes. (shrink)

Reductionism is a central issue in the philosophy of biology. One common objection to reduction is that molecular explanation requires reference to higher-level properties, which I refer to as the context objection. I respond to this objection by arguing that a well-articulated notion of a mechanism and what I term mechanism extension enables one to accommodate the context-dependence of biological processes within a reductive explanation. The existence of emergent features in the context could be raised as an objection to the (...) possibility of reduction via this strategy. I argue that this objection can be overcome by showing that there is no tenable argument for the existence of emergent properties that are not susceptible to a reductive explanation. (shrink)

The received view is that Kant denies all moral luck. But I show how Kant affirms constitutive moral luck in passages concerning radical evil from Religion within the Boundaries of Mere Reason. First, I explicate Kant’s claims about radical evil. It is a morally evil disposition that all human beings have necessarily, at least for the first part of their lives, and for which they are blameworthy. Second, since these properties about radical evil appear to contradict Kant’s even more famous (...) claims about imputation, ‘ought implies can’, and free will, I unpack Henry Allison’s proof of radical evil and show how it is consistent with interpretations of Kant’s broader views about morality. Third, I define and illustrate the category of constitutive moral luck and argue that Kant embraces the existence of constitutive moral luck given Allison-style interpretations of radical evil. This provides a reason for philosophers to reject the received view, and it creates an occasion for Kantians and Kant scholars to check their reasons if they deny moral luck. (shrink)

Down syndrome (DS) impacts several brain regions including the hippocampus and surrounding structures that have responsibility for important aspects of navigation and wayfinding. Hence it is reasonable to expect that DS may result in a reduced ability to engage in these skills. Two experiments are reported that evaluated route-learning of youth with DS, youth with intellectual disability (ID) and not DS, and typically developing (TD) children matched on mental age (MA). In both experiments, participants learned routes with eight choice point (...) presented via computer. Several objects were placed along the route that could be used as landmarks. Participants navigated the route once with turn indicators pointing the way and then retraced the route without them. In Experiment 1 we found that the TD children and ID participants performed very similarly. They learned the route in the same number of attempts, committed the same number of errors while learning the route, and recalled approximately the same number of landmarks. The participants with DS performed significantly worse on both measures of navigation (attempts and errors) and also recalled significantly fewer landmarks. In Experiment 2, we attempted to reduce TD and ID vs DS differences by focusing participants’ attention on the landmarks. Half of the participants in each group were instructed to identify the landmarks as they passed them the first time. The participants with DS again committed more errors than the participants in the ID and TD groups in the navigation task. In addition, they recalled fewer landmarks. While landmark identification improved landmark memory for both groups, it did not have a significant impact on navigation. Participants with DS still performed more poorly than did the TD and ID participants. Of additional interest, we observed that the performance of persons with DS correlated with different ability measures than did the performance of the other groups. The results the two experiments point to a problem in navigation for persons with DS that exceeds expectations based solely on intellectual level. (shrink)

While scholars of, and participants in, social movements, electoral politics, and organized labor are deeply engaged in contrasting different theories of how political actors should organize, little recent philosophical work has asked what social organizing is. This paper aims to answer this question in a way that can make sense of typical organizing- related claims and debates. It is intuitive that what social organizing does is bring about some kind of collectivity. However, I argue that the varieties of collectivity most (...) amply theorized by analytic philosophers in recent years, including grouphood and collective intentionality, are not the right kinds to embed in a theory of social organizing. I ultimately argue that the sort of collectivity that organizing characteristically brings about is a special kind of causal complementarity among agents’ actions— and that while this can exist alongside grouphood and collective intentionality, it is not the same thing as either. The notion of social organizing that emerges is one that can clarify, without trivializing, a number of pressing contemporary debates about how normal people should conduct themselves as interconnected political actors. (shrink)

Elizabeth Lanphier and Uchenna E. Anani provide a powerful argument for the value of a trauma-informed approach to the ethics consultation, which acknowledges the perspectives of all stakeho...

Ethics and school business officials -- Making ethical decisions -- Ethics for school business officials -- Examining personal and professional codes of ethics -- Approaching ethical dilemmas -- Human resource management -- Financial resource management -- Facility, property, and information management -- Ancillary services : transportation.

Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...) work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

Informed consent is the gateway to research participation. We report on the results of the formative evaluation that follows the electronic informed consent process for the All of Us Research Program. Of the nearly 250,000 participants included in this analysis, more than 95% could correctly answer questions distinguishing the program from medical care, the voluntary nature of participation, and the right to withdraw; comparatively, participants were less sure of privacy risk of the program. We also report on a small mixed-methods (...) study of the experience of persons of very low health literacy with All of Us informed consent materials. Of note, many of the words commonly employed in the consent process were unfamiliar to or differently defined by informants. In combination, these analyses may inform participant-centered development and highlight areas for refinement of informed consent materials for the All of Us Research Program and similar studies. (shrink)

Ecological restoration and native landscaping are increasing, particularly in the American Midwest, where they form part of the area's history and culture of conservation. But practitioners rarely pause to ask philosophical questions related to categories of native and invasive or human control and harmony with nature. This article brings philosophy into conversation with practice, using members of Wild Ones Native Landscaping, a non-profit headquartered in Neenah, WI, as a case study. Philosophers and ethicists who are studying Ecological Restoration and Native (...) Landscaping can learn valuable lessons – in practicality, aesthetics and flexibility – from practitioners such as the Wild Ones. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

Ethics courses are most commonly evaluated using reaction measures. However, little is known about the specific types of reaction data being collected and how these reaction data relate to improvements in trainee performance. Using a sample of 381 ethics training sessions, major reaction data categories were identified. Content and course satisfaction were the most frequently collected types of reaction criteria. Furthermore, content relevance and course satisfaction showed strong, positive relationships with performance criteria, whereas content satisfaction demonstrated a moderate, negative relationship. (...) These results and future directions for ethics training evaluation are discussed. (shrink)

To address climate change fairly, many conflicting claims over natural resources must be balanced against one another. This has long been obvious in the case of fossil fuels and greenhouse gas sinks including the atmosphere and forests; but it is ever more apparent that responses to climate change also threaten to spur new competition over land and extractive resources. This makes climate change an instance of a broader, more enduring and - for many - all too familiar problem: the problem (...) of human conflict over how the natural world should be cared for, protected, shared, used, and managed. -/- This work develops a new theory of global egalitarianism concerning natural resources, rejecting both permanent sovereignty and equal division, which is then used to examine the problem of climate change. It formulates principles of resource right designed to protect the ability of all human beings to satisfy their basic needs as members of self-determining political communities, where it is understood that the genuine exercise of collective self-determination is not possible from a position of significant disadvantage in global wealth and power relations. These principles are used to address the question of where to set the ceiling on future greenhouse gas emissions and how to share the resulting emissions budget, in the face of conflicting claims to fossil fuels, climate sinks, and land. It is also used to defend an unorthodox understanding of responsibility for climate change as a problem of global justice, based on its provenance in historical injustice concerning natural resources. (shrink)

There is an ethics of blaming the person who deserves blame. The Christian scriptures imply the following no-vengeance condition: a person should not vengefully overtly blame a wrongdoer even if she gives the wrongdoer the exact negative treatment that he deserves. I explicate and defend this novel condition and argue that it demands a revolution in our blaming practices. First, I explain the no-vengeance condition. Second, I argue that the no-vengeance condition is often violated. The most common species of blame (...) involves anger; anger conceptually includes a desire for vengeance; and there are many pleasures in payback. Third, I clarify that it is possible to blame non-vengefully in anger and highlight three good uses for anger in non-vengeful blame. Fourth, I offer two reasons that justify the divine command prohibiting vengeance, and I note that the Christian God is merely sufficient to make non-vengeance morally obligatory. Fifth, I defend the no-vengeance condition against four biblical objections. (shrink)

An ethical dilemma exists regarding client referral. Standards 2.01(b) (Boundaries of Competence) and 3.01 (Unfair Discrimination) of the American Psychological Association's Ethical Principles of Psychologists Code of Conduct provide psychologists with contradictory reasons to take possibly conflicting and incompatible courses of action when considering whether to refer a client. The professional literature that has explored the benefits of referring clients when the psychologist does not believe that he or she is able to work with the client's presenting concern, however, has (...) failed to examine the times in which referring may not be appropriate and, more specifically, may be an act of discrimination. This article seeks to initiate the discussion around this issue. (shrink)

According to the Free Will Explanation of a traditional view of hell, human freedom explains why some people are in hell. It also explains hell’s punishment and finality: persons in hell have freely developed moral vices that are their own punishment and that make repentance psychologically impossible. So, even though God continues to desire reconciliation with persons in hell, damned persons do not want reconciliation with God. But this moral vice explanation of hell’s finality is implausible. I argue that God (...) can and would make direct or indirect alterations in their character to give them new motivational reasons that re-enable their freedom to repent. Subsequently, I argue that it is probable that each damned person will be saved eventually, because there is a potential infinity of opportunities for free repentance. Thus, if the Free Will Explanation’s descriptions of hell and divine love are correct, it is highly probable that each person in hell escapes to heaven. (shrink)

Wallace Martin's response to "Literary Criticism and Its Discontents" is anything but naive. Its most sophisticated device is to posit my invention of a "naive reader" and to suggest that I would place the New Critics and their heirs in that category. But when I see the movement of criticism after Arnold as exhibiting an anti-self-consciousness principle or being so worried about a hypertrophy of the critical spirit that the spirit is acknowledged only by refusing its seminal or creative force, (...) I am not alleging naiveté but "organized innocence," or the privileged assignment of some given, intuitive power of creation to the area of art which excludes the area of philosophy or philosophically-minded commentary. This defensive partition of the critical and the creative spirit, which recognizes the intelligence of the creative writer but refuses the obverse proposition that there may be creative force in the critical writer, I have elsewhere named the Arnoldian concordat. Geoffrey Hartman, professor of English and comparative literature at Yale University, is the author of Criticism in the Wilderness. (shrink)

Although scientific images have begun to receive significant attention from philosophers, one type of image has thus far been ignored: moving images. As techniques such as live cell imaging and videomicroscopy are becoming increasingly important in many areas of biology, however, this oversight needs to be corrected. Biologists often claim that there are relevant differences between video and static images. Most interesting is the idea that video images allow us to see causal relationships. By identifying the conditions that would be (...) required for this to be true and showing that they are not satisfied at the micro level, I will show that videomicroscopy does not provide us with special access to causal information. †To contact the author, please write to: Department of Philosophy, University of Calgary, 2500 University Dr. NW, Calgary, Alberta T2N 1N4; e-mail: [email protected]. (shrink)

Bringing to light new facets in the philosophy of Emmanuel Levinas and William James, Megan Craig explores intersections between French phenomenology and American pragmatism.

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

A currently popular proposal for fairly distributing emission quotas is the equal shares view, which holds that that emission quotas should be distributed to all human beings globally on an equal per capita basis. In this paper I aim to show that a number of arguments in favour of equal shares are based on a misleading analysis of climate change as a global commons problem. I argue that a correct understanding of the way in which climate change results from the (...) overuse of a global commons shows those who defend equal shares using commons arguments to be harbouring more controversial commitments than might at first appear. I then discuss two options for equal shares theorists who wish to maintain the view in the face of my critique, and attempt to show that one approach holds more promise than the other. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I Know You Have to Stay … I Wish I Could, I Wish I CouldMegan K. SkaffIn the world of healthcare, I advocate for the scores of youth who have had Adverse Childhood Experiences (ACEs). I work to understand where the child has been so we can learn the extent of the trauma that the child has been through. While working for a facility as the Street Outreach Case (...) Manager, my priority was based mainly on one girl, let us call her Tawny. I knew Tawny was going to be a very difficult client to work with the moment I realized she did not trust anyone in her own life, let alone the facility I worked in. She would not talk to a single staff member. However, being her case manager, it was my job to get her to trust me so I could crack her case and really get down to the problems she was facing. I promised myself the day I met Tawny that I would never cast one judgment upon this girl, and I made good on that promise until this very day.I find it true that we are all raised in different situations. Tawny endured such horrific childhood experiences that she voluntarily entered herself into our organization. My specialty was the homeless and runaway case manager. Hence, the reason she ended up on my caseload. After running many different tests, I learned that her ACEs score was a ten out of ten. To her, everything she had endured that warranted this score was baseline normal; she did not see her experiences as traumatic, she just saw them as a piece of her life. For me as her case manager, looking at this ten was devastating. I wanted to know everything I could that went into this high score. I needed Tawny to learn to trust me so I could understand what was going on in her home life and better understand her and her trust issues.Just a side note, the staff around me strongly hated Tawny. The worst part about this was that she knew it because they vocalized it. The staff [End Page 5] was so horrible that they would not even pretend to her face that they liked her. The one job they had as staff—to make her feel welcomed and loved in an environment full of broken kids—they could not do. There was no question as to why I struggled to build a relationship with my most vulnerable yet strongest client. Tawny would not let anyone see her as vulnerable. She did not want to be vulnerable because to her vulnerability meant weakness.I was determined to build a solid foundation of trust with Tawny. It was difficult, but I did it. At best, this process took weeks, maybe close to over a month. After many days of her asking other staff, "why is this b**** still in here," and her finally, slowly inching closer to me to say, "Sup," and me answering, "Just waiting for you to talk to me." This answer would make her smile, even though she tried hard not to. As much as she did not want it to be true, I was the only person she wanted to hang out with on the floor. She did not want anything to do with the kids or the staff. She knew the kids on the floor were toxic for her, and she wanted a better life for herself. She knew the staff were toxic for her as well.She started to ask daily where I was, so I started making sure I was on the floor every day. I gave her my work cell and wrote it in the call book along with a message that she had permission to call at any time, no matter day or night. Staff hated that. I did not care. Let me tell you, she tested it to its limits. If she called me at 3:00 AM, I would answer. She would say she was calling to say goodnight; when really, she just needed to know someone would be there. She needed to know she could trust me... (shrink)