Ontic Therapy is briefly defined. I discuss the early context within which the development of Ontic Therapy unfolds and provide the reader some preliminary heuristic tools for engaging in this novel therapy.

The paper discusses objections against non-hidden variable versions of the epistemic conception of quantum states—the view that quantum states do not describe the properties of quantum systems but reflect, in some way to be specified, the epistemic conditions of agents assigning them. In the first half of the paper, the main motivation for the epistemic conception of quantum states is sketched, and a version of it is outlined, which combines ideas from an earlier study of it with elements of Richard (...) Healey's recent pragmatist interpretation of quantum theory. In the second half, various objections against epistemic accounts of quantum states are discussed in detail, which are based on criticisms found in the literature. Possible answers by the version outlined here are compared with answers from the quantum Bayesian point of view, which is at present the most discussed version of the epistemic conception of quantum states. (shrink)

El psicoanálisis existencial es una de esas críticas constructivas derivadas del psicoanálisis empírico que intenta abrirse camino como alternativa, renovación y modelo de terapia psicoanalítica. Ha encontrado una fundamentación óntico-ontológica desde la cual mostrar al ser descrito tal como se manifiesta en tres estadios concretos: el para-sí, en-sí y para-otro, para llegar a ver que las relaciones con los otros son las que nos provocan esos desequilibrios psíquicos. Nuestro psicoanálisis se plantea como una superación al psicoanálisis empírico en el rechazo (...) al postulado del inconsciente y en la elección que renuncia a suponer una acción mecánica del medio sobre el sujeto considerado a abandonar la simbología utilizada hasta entonces. El psicoanálisis existencial deberá ser enteramente flexible y amoldable a los menores cambios observables en el sujeto, ya que se trata de descubrir una elección no un estado. Como el psicoanálisis existencial tiene como objeto descubrir una elección, deberá tener siempre presente que su objeto no es algo hundido en las tinieblas del inconsciente, sino una determinación consciente y libre. Finalmente, la propuesta es una terapia psicoanalítica ya que la persona es una constante proyección en el mundo, el método existencial, se orienta desde el principio hacia una comprensión del ser y no debe asignarse otro objetivo que encontrar el ser y la manera de ser del ser frente a ese ser.Existential Psychoanalysis is one of the most constructive critics based on empirical psychoanalysis which attempts to open up new paths as an alternative, renovation and model of psychoanalytical therapy. An ontic-ontological foundation has been discovered from which it can be described in 3 different concrete states: for someone, in someone or for someone else, to be able to see that our relationships with others are those which cause psychic unbalance. Our psychoanalysis overcomes empirical psychoanalysis in rejection to postulate from the unconscious and in the election which renounces to suppose a mechanical action from the medium on the subject considered to abandon the symbology used until then. Existential psychoanalysis should be completely flexible and changeable to the minor changes which can be observed in the subject, now that it is a case of discovering an election not a state. Due to the fact that the psychoanalysis has as objective to discover an election, it should always have present that its objective is not something united in the darkness of the unconscious, but more of a conscious and free determination. Lastly, the proposition is a psychoanalytical therapy now that the person is a constant projection in the world, the existential method, which is oriented from the beginning towards an understanding of the being and another objective should not be assigned other than find ways of being and the way of being against that being. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The vignettes (...) described a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)

:Since the advent of recombinant DNA technology, expectations about the potential for altering genes and controlling our biology at the fundamental level have been sky high. These expectations have gone largely unfulfilled. But though the dream of being able to control our biology is still far off, gene editing research has made enormous strides toward potential clinical use. This paper argues that when it comes to determining permissible uses of gene editing in one important medical context—germline intervention in reproductive medicine—issues (...) about enhancement and eugenics are, for the foreseeable future, a red herring. Current translational goals for gene editing research involve a different kind of editing than would be required to achieve manipulation of complex traits such as intelligence, and there are more pressing questions that need attention if clinical use of gene editing in reproductive medicine ever becomes a possibility. (shrink)

Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies. Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, (...) they are reconstructed in similar ways. This paper looks at the most recent RT to be permitted in the UK, mitochondria replacement therapy. Despite controversial media headlines surrounding the technique, MRT is in fact an example of how science and regulation seek to expand models of traditional relatedness in a way that doesn’t challenge the existing order. Yet, like other RTs, while attempts are made to ensure it doesn’t push traditional boundaries too far, fissures and inconsistencies appear in law and culture, which give interesting insights into how genetics, parentage and identity are being mediated in new but familiar ways. (shrink)

How does law effect well-being? Can school rules influence the feel-good factor among children? If a self-perception of being ‘good’ improves well-being, people would prefer to be good—even children. But traditional school rules are often contrary to the principles of well-being, and create ‘good criminals’. Starting from the seemingly absurd truth—‘crime is caused by the law’— the paper proposes that children should learn to view law critically and creatively. Then, through a novel application of Occupational Therapy , and using (...) ‘law’ to focus social agency, a case study develops ‘The law of school dress’ as a public good. The result reflects Jeremy Bentham’s Principle of Utility. Philosophy of OT reminds us that the ultimate purpose of education is not just to learn: it is to improve well-being through learning as meaningful ‘occupation’. And ‘law’ has a part to play. (shrink)

Existing metaphysical accounts of mechanisms commit to the existence of objects or entities posited in scientific theories, and thus fall within the category of maximal metaphysics. In this paper, I demonstrate the incompatibility of object-based metaphysics of mechanisms with the prevailing trend in the philosophy of physics by discussing the so-called bottoming-out problem. In response, I propose and flesh out a structuralist metaphysics of mechanisms based on Ontic Structural Realism (OSR), which is a kind of minimal metaphysics. I argue (...) that the metaphysical underpinnings of mechanisms are structures, whose metaphysical nature is elaborated through comparison with existing metaphysical theories of mechanisms. After that, I address the concern of whether objects in mechanisms can be accommodated in my account by invoking existing metaphysical theories of objects in special science by structuralists, such as Ladyman, J., & Ross, D. ( 2007 ). _Every Thing Must Go: Metaphysics Naturalized_. Oxford University Press.)’s real pattern account, and suggesting a potential alignment between OSR and processual ontology. Finally, I demonstrate how my view can naturally serve as the metaphysics for Mechanism 2.0 and be applied to systems biology. (shrink)

In this essay I argue that a comprehensive understanding of addiction and its treatment should include an existential perspective. I provide a brief overview of an existential perspective of addiction and recovery, which will contextualize the remainder of the essay. I then present a case study of how the six-step philosophical practice method of Logic-Based Therapy can assist with issues that often arise in addiction treatment framed through an existential perspective.

What proper role should considerations of risk, particularly to research subjects, play when it comes to conducting research on human enhancement in the military context? We introduce the currently visible military enhancement techniques (1) and the standard discussion of risk for these (2), in particular what we refer to as the ‘Assumption’, which states that the demands for risk-avoidance are higher for enhancement than for therapy. We challenge the Assumption through the introduction of three categories of enhancements (3): therapeutic, (...) preventive, and pure enhancements. This demands a revision of the Assumption (4), alongside which we propose some further general principles bearing on how to balance risks and benefits in the context of military enhancement research. We identify a particular type of therapeutic enhancements as providing a more responsible path to human trials of the relevant interventions than pure enhancement applications. Finally, we discuss some possible objections to our line of thought (5). While acknowledging their potential insights, we ultimately find them to be unpersuasive, at least provided that our proposal is understood as fully non-coercive towards the candidates for such therapeutic enhancement trials. (shrink)

The prescription of growth hormone therapy for children who are not growth hormone deficient is one of the controversies in contemporary paediatric endocrinology. Is it morally appropriate to enhance the growth, by means of medical treatment, of a child wish idiopathic short stature? The medical, moral, and philosophical questions in this area are many. Data on the effects of human growth hormone (hGH) treatment will not on their own provide us with answers, as these effects have to be evaluated (...) from a normative perspective. In this article we consider hGH treatment for children of idiopathic short stature from three normative perspectives: the goals of medicine, the good of the patient, and the public good. We argue that the prevention of psychological and social problems due to short stature (and not merely the enhancement of growth) should be the ultimate goal of medical treatment and research. (shrink)

I argue that Descartes intended the so-called ontological "argument" as a self-validating intuition, rather than as a formal proof. The textual evidence for this view is highly compelling, but the strongest support comes from understanding Descartes's diagnosis for why God's existence is not 'immediately' self-evident to everyone and the method of analysis that he develops for making it self-evident. The larger aim of the paper is to use the ontological argument as a case study of Descartes's nonformalist theory of deduction (...) and his method of analysis, showing how he conceives the latter as a form of philosophical therapy. (shrink)

Abstract: The notion that philosophy can be practised as a kind of therapy has become a focus of debate. This article explores how philosophy can be practised literally as a kind of therapy, in two very different ways: as philosophical therapy that addresses “real-life problems” (e.g., Sextus Empiricus) and as therapeutic philosophy that meets a need for therapy which arises in and from philosophical reflection (e.g., Wittgenstein). With the help of concepts adapted from cognitive and clinical (...) psychology, and from cognitive linguistics, the article shows that both philosophical projects address important and literally therapeutic tasks and explains how they can do so with genuinely philosophical argument and analysis. This brings into view new applications for philosophy, a need for therapy in core areas of the subject, and the outline of a new approach to meet what will be shown to be a central need. (shrink)

Obwohl die Substitutionsbehandlung nachweislich den Gesundheitszustand opiatabhängiger Patienten verbessern und die Beschaffungskriminalität reduzieren kann, bestehen enge gesetzliche Regelungen, die die Therapiefreiheit der behandelnden Ärzte stark begrenzen: So werden durch das Betäubungsmittelgesetz und die zugehörigen Verordnungen nicht nur das Behandlungsziel (Abstinenz) sondern auch notwendige Therapiebausteine definiert, die darauf ausgerichtet sind, die Therapietreue des Patienten zu kontrollieren. Deutsche Ärzte, die die strengen Auflagen nicht strikt befolgten, wurden zu Gefängnisstrafen verurteilt. Wie der Artikel zeigt, fördern die bestehenden Gesetze eine „kontrollierende“ statt einer motivierenden (...) ärztlichen Behandlung, ohne wichtige Ziele, wie den Schutz der Allgemeinheit vor einer illegalen Verbreitung illegaler Opioide, vollständig zu erreichen. Zusammenfassend zeigt der Artikel, dass eine stärker am Wohl der Patienten ausgerichtete Substitutionsbehandlung (einschließlich notwendiger Kontrolluntersuchungen) mit hoher Wahrscheinlichkeit auch die Öffentlichkeit wirksamer vor den potenziellen Gefahren einer illegalen Verbreitung von gefährlichen Opioiden schützt als die Befolgung abstrakter, restriktiver gesetzlichen Normen. (shrink)

Jean Ayres invented Sensory Integration for children experiencing learning and social difficulties because, according to Ayres, they could not adequately integrate information from multiple sensory modalities. She established a scientific basis for her identification of children with sensory integrative difficulties, using statistical techniques to identify symptoms and neuroscience to determine a cause. She was an unusually reflective practitioner who catalyzed a community of practice around SI without becoming a guru—indeed, she encouraged her students to come up with their own ideas (...) and test them empirically. She felt isolated from the growing field of Occupational Therapy yet is viewed as one of its greatest pioneers. After her death in 1988, the SI community gradually began to argue about fundamental issues like what should constitute an appropriate diagnosis and set of tests for SI. At present, the network is fragmented to the point where some of the opposing positions may be incommensurable with each other, which would require a trading zone. (shrink)

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological treatment. This (...) study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach, offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that ADIT was acceptable for patients with complex/major depression, that they were likely to refer to ADIT in the future that the use of arts was likely to improve accessibility the use of arts was likely to improve outcomes and that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol. (shrink)

ObjectiveCo-morbid insomnia and sleep apnea is a common and debilitating condition that is more difficult to treat compared to insomnia or sleep apnea-alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia is effective in patients with COMISA, however, those with more severe sleep apnea and evidence of greater objective sleep disturbance may be less responsive to CBTi. Polysomnographic sleep study data has been used to predict treatment response to CBTi in patients with insomnia-alone, but not in patients with (...) COMISA. We used randomized controlled trial data to investigate polysomnographic predictors of insomnia improvement following CBTi, versus control in participants with COMISA.MethodsOne hundred and forty five participants with insomnia and sleep apnea [apnea-hypopnea index ≥ 15] were randomized to CBTi or no-treatment control. Mixed models were used to investigate the effect of pre-treatment AHI, sleep duration, and other traditional, and novel [quantitative electroencephalography ] polysomnographic predictors of between-group changes in Insomnia Severity Index scores from pre-treatment to post-treatment.ResultsCompared to control, CBTi was associated with greater ISI improvement among participants with; higher AHI, less wake after sleep onset, and less N3 sleep. No quantitative electroencephalographic, or other traditional polysomnographic variables predicted between-group ISI change.DiscussionAmong participants with COMISA, higher OSA severity predicted a greater treatment-response to CBTi, versus control. People with COMISA should be treated with CBTi, which is effective even in the presence of severe OSA and objective sleep disturbance. (shrink)

Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic (...) increase in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action. Methods: We conducted a thorough systematic search of studies published until October 2017, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning. Results: Seventy-five studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analysed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy. Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EDMR therapy are still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions. (shrink)

ObjectiveTo explore the effect of modified constraint-induced movement therapy on upper limbs residual dysfunction for infancy with the sequelas of unilateral brachial plexus injury.MethodsSingle blind randomized controlled trial of mCIMT vs. standard care. An enrolling 31 infants with a uBPI exhibiting residual dysfunction of the affected upper limb for over 6 months was conducted. And functional outcomes pertaining to the affected upper limb were assessed via AMS, GRES, RHS, and MSS at 0, 3, and 6 months after treatment.ResultsNo differences (...) were found in baseline AMS, MSS, GRES, or RHS between the control and mCIMT groups [F = 0.062, P = 0.086; F = 0.483, P = 0.499; F = 0.272, P = 0.610; Z = −0.336, P = 7.373]. At the 3- and 6-month follow-up time points, AMS, MSS, and GRES scores were significantly improved over baseline in both groups [mCIMT: F = 183.750, 128.614, 110.085, P < 0.05; Control: F = 204.007, 75.246, 51.070, P < 0.05]. No significant differences were found between two treatment groups at the 3-month follow-up time point [F = 0.565, P = 0.465; F = 0.228, P = 0.641; F = 0.713, P = 0.413; Z = −0.666, P = 0.505]. However, at the 6-month follow-up time point, AMS and MSS scores were significantly improved in the mCIMT group relative to the control group [F = 8.077, P = 0.013; F = 18.692, P = 0.001].ConclusionmCIMT may benefit the rehabilitation of residual upper limb dysfunction associated with a uBPI in infants.Clinical Trial Registration[www.chictr.org.cn], identifier [ChiCTR1900022119]. (shrink)

Using a longitudinal case study design, we have tracked the recovery of motor function following severe traumatic brain injury (TBI) through a multimodal neuroimaging approach. In 2006, Canadian Soldier Captain (retired) Trevor Greene (TG) was attacked with an axe to the head while on tour in Afghanistan. TG continues intensive daily rehabilitation, which recently included the integration of physical therapy (PT) with neuromodulation using translingual neurostimulation (TLNS) to facilitate neuroplasticity. Recent findings with PT+TLNS demonstrated that recovery of motor function (...) occurred beyond conventional time limits, currently extending past 14-years post-injury. To investigate whether PT+TLNS similarly resulted in associated cognitive function improvements, we examined event-related potentials (ERPs) with the brain vital signs framework. In parallel with motor function improvements, brain vital signs detected significant increases in basic attention (as measured by P300 response amplitude) and cognitive processing (as measured by contextual N400 response amplitude). These objective cognitive improvements corresponded with TG’s self-reported improvements, including a noteworthy and consistent reduction in ongoing symptoms of post-traumatic stress disorder (PTSD). The findings provide valuable insight into the potential importance of non-invasive neuromodulation in cognitive rehabilitation, in addition to initial indications for physical rehabilitation. (shrink)

Recombinant DNA technology will soon allow physicians an opportunity to carry out both somatic cell- and Germ-Line gene therapy. While somatic cell gene therapy raises no new ethical problems, gene therapy of gametes, fertilized eggs or early embryos does raise several novel concerns. The first issue discussed here relates to making a distinction between negative and positive eugenics; the second issue deals with the evolutionary consequences of lost genetic diversity. In distinguishing between positive and negative eugenics, the (...) concept of malady is applied as a definitional criterion for identifying genetic disorders that could qualify for Germ-Line therapy. Because gene replacement techniques are currently unavailable for humans, and because even if they were possible the number of people involved would be quite small, the loss of diversity concern seems moot. Finally, we dissuss the issue of iatrogenic disorders associated with gene therapy and discuss several ‘real world considerations.’. (shrink)

Classic serotonergic psychedelics are experiencing a clinical revival, which has also revived ethical debates about psychedelic-assisted therapy. A particular issue here is how to prepare and protect patients from the vulnerability that the psychedelic state creates. This article first examines how this vulnerability manifests itself, revealing that it results from an impairment of autonomy: psychedelics diminish decision-making capacity, reduce controllability, and limit resistance to external influences. It then analyzes the strengths and weaknesses of five safety measures proposed in the (...) literature, what aspect of the patient’s vulnerability they seek to reduce, and how they can be optimized. The analysis shows that while preparatory sessions, advance directives, and specific training and oversight are useful, starting with a lower dosage and no therapy is less so. Finally, the article presents a safety measure that has been overlooked in the literature but could be highly effective and feasible: bringing a close person to the psychedelic session. (shrink)

This article discusses the potential of using interactive environments in autism therapy. We specifically address issues relevant to the Aurora project, which studies the possible role of autonomous, mobile robots as therapeutic tools for children with autism. Theories of mindreading, social cognition and imitation that informed the Aurora project are discussed and their relevance to the project is outlined. Our approach is put in the broader context of socially intelligent agents and interactive environments. We summarise results from trials with (...) a particular mobile robot. Finally, we draw some comparisons to research on interactive virtual environments in the context of autism therapy and education. We conclude by discussing future directions and open issues. (shrink)

Actualmente los estudios de Ciencia, Tecnología y Sociedad constituyen un importante espacio de trabajo en la política pública, la educación y la investigación. La introducción de nuevos procedimientos y tecnologías en la atención médica debe analizarse desde la perspectiva de los estudios de CTS porque requiere de un sustento científico-tecnológico y tiene que cumplir, entre otros, con los requisitos éticos de aplicabilidad a los seres humanos. La utilización secuencial de los antimicrobianos en el tratamiento postoperatorio de la apendicitis aguda complicada (...) en los niños, constituye una modificación de la terapéutica comúnmente empleada en Cuba y en muchas instituciones de salud del mundo. El presente trabajo muestra una reflexión sobre los pilares científicos, tecnológicos y sociales que sustentan la aplicación de un nuevo protocolo de tratamiento con el uso secuencial de los antimicrobianos en los niños con apendicitis aguda complicada. Currently the studies of science, technology and society are an important field on the research, education and public policy. The introduction of new procedures and technologies on the health care system should be considered throughout the science, technology and society point of view. Sequential antibiotic therapy in the postoperative management of children with complicated acute appendicitis is analternative of the commonest therapeutic management for these children in Cuba and in many health care justifys around the world. This paper show the significance of science, technology and society associated with the use of the sequential antibiotic therapy for children with complicated acute appendicitis. (shrink)

Current debate and policy surrounding the use of genetic editing in humans often relies on a binary distinction between therapy and human enhancement. In this paper, we argue that this dichotomy fails to take into account perhaps the most significant potential uses of CRISPR-Cas9 gene editing in humans. We argue that genetic treatment of sporadic Alzheimer’s disease, breast- and ovarian-cancer causing BRCA1/2 mutations and the introduction of HIV resistance in humans should be considered within a new category of genetic (...) protection treatments. We find that if this category is not introduced, life-altering research might be unnecessarily limited by current or future policy. Otherwise ad hoc decisions might be made, which introduce a risk of unforeseen moral costs, and might overlook or fail to address some important opportunities. (shrink)

The development of gene therapy has always come with the expectation that it will offer a cure for various disorders, of which hemophilia is a paradigm example. However, although the term is used regularly, it is unclear what exactly is meant with “cure”. Therefore, the aim of this paper is to analyse how the concept of cure is used in practice and evaluate which of the interpretations is most suitable in discussions surrounding gene therapy. We analysed how cure (...) is used in four different medical fields where the concept raises discussion. We show that cure can be used in three different ways: cure as normalization of the body, cure as obtaining a normal life, or cure as a change in identity. We argue that since cure is a practical term, its interpretation should be context-specific and the various uses can exist simultaneously, as long as their use is suitable to the function the notion of cure plays in each of the settings. We end by highlighting three different settings in the domain of hemophilia gene therapy in which the term cure is used and explore the function(s) it serves in each setting. We conclude that in the clinical application of gene therapy, it could be better to abandon the term cure, whereas more modest and specified definitions of cure are required in the context of health resource allocation decisions and decisions on research funding. (shrink)

Although many philosophers have, throughout history, regarded themselves as answering the skeptic, the question arises whether answering the skeptic is the thing to do. If not, the question becomes how else to respond to her. Wittgenstein-inspired stances are, in general, therapeutic. In this article I focus on the problem of other minds in order to analyze and compare the different shapes such therapeutic stances may have. I begin by showing how crucial resisting the temptation to answer the skeptic was for (...) John McDowell’s early formulations of disjunctivism in the 1980s. In his article “Criteria, Defeasibility, and Knowledge” I identify substantial positions such as the rejection of highest common factor views, the diagnosis of the connection between such highest common factor views and an conception of appearances, as well as the proposal of a non-Cartesian, or modest, approach to indistinguishability for a subject. Whatever his success in these other enterprises, McDowell continues to regard both the temptation to answer the skeptic and a substitute therapeutic stance as epistemologically motivated. But if skepticism is more than an intellectual conundrum, as maintained by Stanley Cavell, the source of such temptation has to be considered in a completely different light. (shrink)

This study reports an analysis using the conversation analytical approach of the use of laughter within a corpus of cognitive therapy sessions. The results relating to eight first encounter sessions reveal that a client’s laughter may accompany disagreement as well as agreement with the therapist. In both cases, the therapist does not reciprocate the client’s laughter and replies by investigating the client in question’s condition, and this approach to the client’s laughter produces significant results in therapeutic work. This article (...) focuses on the asymmetry that characterizes the roles of the psychotherapist and the client in psychotherapy sessions and, in particular, on the part that laughter plays in this type of scenario. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy (...) can be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

Before the advent of fibrinolytic therapy as a gold standard method of care for cases of acute ischemic stroke in Romania, issues regarding legal medicine aspects involved in this area of medical expertise were already presented and, in the majority of cases, the doctors seem to be unprepared for these situations. The present research illustrates some of the cases in which these aspects were involved, that adressed a clinical center having 6 years of professional experience in the application of (...) fibrinolytic treatment for stroke. The following cases report either situations in which the afore mentioned therapy was not rightfully administrated or legal aspects regarding the obtainment of informed consent. Obtaining informed consent is a mandatory procedure, which takes time, to the detriment of application of fibrinolytic treatment. (shrink)

Deciding whether to grant an expanded access request for a child whose sibling is enrolled in a gene therapy trial involves a number of complex factors: considering the best interests of the child, the psychosocial and economic impact on the family, and the concerns and obligations of researchers. Despite the challenges in coming to a substantively fair outcome in cases of discordant eligibility, creating a procedurally fair decision-making process to adjudicate requests is essential.

In a recent study, Lantian and colleagues (2024) measured public attitudestoward the use of ‘love drugs’ as introduced through the work of Earp,Savulescu, and their collaborators. Use of a “revolutionary pill” (described as“100% reliable”) to bring about love is seen as less morally acceptable thanpsychological therapy toward the same end, and this is partly explained byperceptions that the pill-induced love is less authentic. However, the “pill” inquestion bears little resemblance to the real-world uses of love drugs discussedby Earp and (...) Savulescu, such as MDMA-assisted couples therapy. In this partialreplication and extension study, we show that more ecologically valid ‘lovedrugs’ scenarios lead to much higher ratings of moral acceptability and perceived authenticity of the resulting love. (shrink)

The purpose of the present study was to evaluate the effectiveness of a physical activity intervention program designed to enhance levels of engagement in PA. Despite robust evidence supporting the beneficial effects of PA on overall health, only about 22% of individuals engage in the recommended minimum amount of PA. Recent surveys suggested that most individuals express intentions to be physically active, though the psychological state of amotivation dismissed these struggles. In the current study, we pilot-tested a new intervention program, (...) aimed at enhancing engagement in PA among sedentary individuals. The intervention was based on two behavioral change and motivational psychological frameworks: Self-Determination Theory and Acceptance and Commitment Therapy. During a 14-week intervention program, 94 sedentary Israeli college students were randomly assigned into one of three groups: SDT and ACT-based intervention, traditional intervention, and a non-treatment group. Prior to and following the intervention, participants completed the Behavioral Regulation in Exercise Questionnaire-3 to examine motivation to exercise and the International Physical Activity Measurement IPAQ to evaluate their training frequency. Results showed that the SDT and ACT-based intervention group exhibited a significant increase in motivation to exercise between time 1 and time 2, while the other two groups showed insignificant differences in motivation to exercise. Furthermore, neither of the groups showed significant differences in their training frequency per week. However, those in the SDT and ACT-based groups reported an increase in activity intensity from time 1 to time 2 compared to the two other groups. Further, exercise psychology consultants and scholars can use the intervention protocol and utilize these findings to improve PA behaviors and promote health in the general population. Limitations, future directions, and implications are discussed in detail. (shrink)

Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture.Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first (...) time to practice placement education.Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga and Castilla-La Mancha. Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale. All these instruments were also completed 1 week after the end of the clinical practice.Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women and men, when the internship area was not considered.Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome. (shrink)

Is nonhuman animal-assisted therapy a form of exploitation? After exploring possible moral vindications of AAT and after establishing a distinction between "use" and "exploitation," the essay distinguishes between forms of animal-assisted therapy that are morally unobjectionable and those modes of it that ought to be abolished.

Summary Giancarlo Trombini presents the continuation of his research on the question of which criteria can be used to assess the progress of therapy in an objectively verifiable way and to make the decision on the completion of therapy. In the first phase of his research, the phenomenological criterion of a qualitative change in the patient’s relations toward the positive and higher complexity was proposed for this purpose. In terms of the working method in analytic therapy, this (...) meant concretely: attention should be paid to what development is shown in the comparison of the relationships that occur in the dream narrative and in the subsequent associations. This criterion was therefore given the name manifest dream/association comparison (MDAC)—comparison between the manifest dream and the subsequent associations. The idea can easily be transferred to those therapy methods, which do not primarily work with reports of dream memories and subsequent associations—also, in other ways of working, it is possible to pay attention, in the way suggested by Trombini, to the qualitative development of the relationships which are thematized by the clients in the course of an hour. To this first criterion, another phenomenological criterion is now added in the present article: that of the “concluding therapeutic turn” (CTT). If the patient’s development reaches this turn in the course of the therapy in one session, this indicates, according to Trombini, that the therapy can soon be concluded. The fulfillment of this criterion can be recognized by the fact that in the sequence of dream narration and subsequent associations in a session, a relational dynamic toward the positive and higher complexity becomes recognizable and that is, at the same time, connected with a reconciliation of the three temporal reference systems (past, present, and future). The achievement of this CTT indicates that the patient is aware of the changes made in therapy and makes it evident to the therapist that the therapy is nearing completion. (shrink)