Empathy

After defining empathy, discussing its measurement, and offering an example of empathy in practice, we present the results of an updated meta-analysis of the relation between empathy and psychotherapy outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r = .31 ( p < .001; 95% confidence interval: .28 –.34), for 59 independent samples and 3599 clients. Although the empathy-outcome relation held equally for different theoretical orientations, there was considerable nonrandom variability. Client and observer perceptions of therapist empathy predicted outcomes better than therapist perceptions of empathic accuracy measures, and the relation was strongest for less experienced therapists. We conclude with practice recommendations, including endorsing the different forms that empathy may take in therapy

Financial signal processing: a self calibrating model

Previous work on multifactor term structure models has proposed that the short rate process is a function of some unobserved diffusion process. We consider a model in which the short rate process is a function of a Markov chain which represents the 'state of the world'. This enables us to obtain explicit expressions for the prices of zero-coupon bonds and other securities. Discretizing our model allows the use of signal processing techniques from Hidden Markov Models. This means we can estimate not only the unobserved Markov chain but also the parameters of the model, so the model is self-calibrating. The estimation procedure is tested on a selection of U.S. Treasury bills and bonds.Bonds

Research on humanistic-experiential psychotherapies

In this chapter we focus on research published since our previous reviews (Greenberg, Elliott & Lietaer, 1994; Elliott, Greenberg & Lietaer, 2004), which covered research published between 1978 and 2001, plus additional earlier research on humanistic-experiential psychotherapy (HEP) outcome that we have been able to track down. A key element of the chapter is a meta-analysis of nearly 200 HEP outcome studies (through 2008) and a survey of the use of the approach with different client groups. In addition, we offer a meta-synthesis of qualitative research on these therapies (cf. Timulak, 2007), and provide a narrative review of recent quantitative research on change processes in HEPs. We conclude by reviewing and integrating the literature reviewed and discuss policy implications

Corrections, Improvements, and Comments on Some Gradshteyn and Ryzhik Integrals

In this paper, we prove that two integrals from Gradshteyn and Ryzhik (2014) [1] (namely, Eqs. 3.937 1 and 3.937 2) provide incorrect results in certain conditions. We derive those conditions herein and provide the corrections required for those two formulas. We furthermore derive improved formulas for the solutions to those integrals that are less complicated, avoid the errors of the original formulas, and work under a larger range of parameter values. The improved formulas are used to verify the results of a few other related integrals from [1]; the previous results need correction in some instances, or are correct but can be extended in other instances. Lastly, we also consider the extended case of complex-valued parameters and derive the resulting formulas.Comment: 27 pages, 0 figures. Submitted to SCIENTIA Series A: Mathematical Sciences. Changes since v1: (1) Submission venue changed from Elsevier Journal of Computational and Applied Mathematics to SCIENTIA. (Paper was out of scope for Elsevier JCAM.) (2) Added MSC codes. (3) Incorporated footnote text into main body tex

An adjudicated hermeneutic single-case efficacy design study of experiential therapy for panic/phobia

This paper illustrates the application of an adjudicated form of Hermeneutic Single Case Efficacy Design (HSCED), a critical-reflective method for inferring change and therapeutic influence in single therapy cases. The client was a 61 year-old European-American male diagnosed with panic and bridge phobia. He was seen for 23 sessions of individual Process-Experiential/Emotion-Focused Therapy. In this study, affirmative and skeptic teams of researchers developed opposing arguments regarding whether the client changed over therapy and whether therapy was responsible for these changes. Three judges representing different theoretical orientations then assessed data and arguments, rendering judgments in favor of the affirmative side. We discuss clinical implications and recommendations for the future interpretive case study research

Therapist empathy and client outcome: an updated meta-analysis

Put simply, empathy refers to understanding what another person is experiencing or trying to express. Therapist empathy has a long history as a hypothesized key change process in psychotherapy. We begin by discussing definitional issues and presenting an integrative definition. We then review measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. We follow this with clinical examples illustrating different forms of therapist empathy and empathic response modes. The core of our review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r= .28 (p< .001; 95% confidence interval: .23 –.33; equivalent of d= .58) for 82 independent samples and 6,138 clients. In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects. Client, observer, and therapist perception measures predicted client outcome better than empathic accuracy measures. We then consider the limitations of the current data. We conclude with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy

Fifty Years of Clinical Legal Education at American University Washington College of Law: The Evolution of A movement in Theory, Practice, and People

Clinical legal education has evolved substantially in the fifty years since Elliott Milstein initiated the clinical model at American University Washington College of Law (“WCL”) that, notwithstanding numerous changes in program and personnel since that time, remains essentially in effect today. In this Article, we explore the theoretical, pedagogical, structural, programmatic, and personnel developments that have occurred during this period. We link these developments to broader developments within the national and international clinical legal education spheres. WCL’s Clinical Program, and its clinical faculty, have been leaders in shaping these developments, but, in the best clinical tradition, we have not done so alone but in dialogue with other colleagues. We conclude with a discussion of the unfinished business of the clinical legal education movement

Occurrence rate of delirium in acute stroke settings

Background and Purpose— Delirium is associated with increased mortality, length of stay, and poor functional outcome following critical illness. The epidemiology of delirium in stroke is poorly described. We sought to collate evidence around occurrence (incidence or prevalence) of delirium in acute stroke. Methods— We searched multiple cross-disciplinary electronic databases using a prespecified search strategy, complemented by hand searching. Eligible studies described delirium in acute (first 6 weeks) stroke. We compared delirium occurrence using random-effects models to describe summary estimates. We assessed risk of bias using the Newcastle-Ottawa tool, incorporating this in sensitivity analyses. We performed subgroup analyses for delirium diagnostic method (confusion assessment method scoring, clinical diagnosis, other), duration and timing of delirium assessment (&gt;1 or &lt;1 week), and performed meta-regression based on the year of publication. Results— Of 8822 titles, we included 32 papers (6718 participants) in the quantitative analysis. Summary estimate for occurrence of delirium was 25% (95% CI, 20%–30%; moderate quality evidence). Limiting to studies at low risk of bias (22 studies, 4422 participants), the occurrence rate was 23% (95% CI, 17%–28%). Subgroup summary estimates suggest that delirium occurrence may vary with assessment method: confusion assessment method, 21% (95% CI, 16%–27%); clinical diagnosis, 27% (95% CI, 19%–38%); other, 32% (95% CI, 22%–43%) but not with duration and timing of assessment. Meta-regression suggested decline in occurrence of delirium comparing historical to more recent studies (slope, 0.03 [SE, 0.004]; P&lt;0.0001). Conclusions— Delirium is common, affecting 1 in 4 acute stroke patients. Reported rates of delirium may be dependent on assessment method. Our estimate of delirium occurrence could be used for audit, to plan intervention studies, and inform clinical practice. Clinical Trial Registration— URL: http://www.crd.york.ac.uk/PROSPERO/. Unique identifier: CRD42015029251

Use of a cAMP BRET Sensor to Characterize a Novel Regulation of cAMP by the Sphingosine 1-Phosphate/G13 Pathway

Regulation of intracellular cyclic adenosine 3',5'-monophosphate (cAMP) is integral in mediating cell growth, cell differentiation, and immune responses in hematopoietic cells. To facilitate studies of cAMP regulation we developed a BRET (bioluminescence resonance energy transfer) sensor for cAMP, CAMYEL (cAMP sensor using YFP-Epac-RLuc), which can quantitatively and rapidly monitor intracellular concentrations of cAMP in vivo. This sensor was used to characterize three distinct pathways for modulation of cAMP synthesis stimulated by presumed Gs-dependent receptors for isoproterenol and prostaglandin E2. Whereas two ligands, uridine 5'-diphosphate and complement C5a, appear to use known mechanisms for augmentation of cAMP via Gq/calcium and Gi, the action of sphingosine 1-phosphate (S1P) is novel. In these cells, S1P, a biologically active lysophospholipid, greatly enhances increases in intracellular cAMP triggered by the ligands for Gs-coupled receptors while having only a minimal effect by itself. The enhancement of cAMP by S1P is resistant to pertussis toxin and independent of intracellular calcium. Studies with RNAi and chemical perturbations demonstrate that the effect of S1P is mediated by the S1P2 receptor and the heterotrimeric G13 protein. Thus in these macrophage cells, all four major classes of G proteins can regulate intracellular cAMP