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Solving Wicked Problems Requires Two-Minds Thinking

  "Wicked problems" are seemingly intractable societal issues that affect many areas of everyday life -- some common examples are how to educate people, how to handle climate change, and how to respond to a pandemic. The term was coined by systems theorists Horst Wittel and Melvin Webber in 1973. Some important characteristics of a wicked problem are that: they have no single definition, so that different people can see the problem in different ways. For example, the COVID-19 pandemic was viewed by some people as an imminent health threat, by others as an economic threat, and by still others as a fundamental conflict between government regulation and personal liberties. Applying any proposed solution to a wicked problem (e.g., people should wear masks to prevent transmission) often creates other problems (e.g., what about people who have trouble breathing, have anxiety, rely on perceiving others' facial expressions, just don't feel like wearing a mask, use the anony...
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The "Shape Shifter" Model of Symptoms

This post is dedicated to my friend and mentor Dr. Paula Meek, who passed away on July 29th. Dr. Meek was crucial to the development of the model described below, and it was she who suggested the "shape shifter" metaphor as its name. Dr. Meek was also a coauthor of my 2018 paper describing Two Minds Theory, and had a major impact on my thinking during her tenure at CU Nursing. I join her many students and trainees in saying that Paula will be deeply missed. Does your mental state cause your behavior, or does your current physiology (influenced by behaviors like sleep, diet, and exercise) cause your mental state? The answer to this question is of course "yes." Or it's "both/and," as we Lutherans like to say about many of life's mysteries. My colleagues and I addressed questions of biology and behavior in a 2012 paper describing the "shape shifter" model for biobehavioral research . Although originally intended as a tool specifically for un...
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Motivational Interviewing 4th Edition: What's New?

Drs. Bill Miller and Steve Rollnick have published a new edition of their bestselling psychotherapy book, Motivational Interviewing . Similar to past editions, this is not just a minor update. Every time that Miller and Rollnick revise their work, they seem to sit down with a blank screen and start to explain their method from scratch, resulting in a completely new book about motivational interviewing. So what's in the new version? One update in the 3rd edition was the introduction of 4 "tasks" of motivational interviewing: engaging, focusing, evoking, and planning. In the new 4th edition, these tasks have become the overarching structure of the book, with a chapter on each one. Other frameworks, like the "MI micro-skills" of OARS (open-ended questions, affirmation, reflection, summarizing) are subsumed into the four tasks (OARS is in the "evoking" chapter now). The new book flows in a way that prior editions didn't always -- they more often had co...
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Symptoms Provide a Window into the Intuitive Mind: New Insights from Fatigue Research

I wrote previously about my colleague Dr. Mustafa Ozkaynak's study of fatigue among emergency-room nurses, which showed how fatigue impairs decision-making, especially at the level of the Narrative Mind. In a new paper that we published from the same dataset, Dr. Ozkaynak's team examined psychometric properties of the Swedish Occupational Fatigue Inventory (SOFI). We found that the emergency-room nurses' experience of fatigue was a good fit with what people have reported in other occupational contexts, with 4 different aspects of fatigue: (a) lack of motivation, (b) physical discomfort, (c) sleepiness, and (d) an overall "lack of energy" scale that both encompasses the other 3 elements of fatigue and also has some unique items associated only with lack of energy. We tested whether 2 additional items from another tool, which are generally understood to measure (e) mental fatigue, would be a meaningful addition to the SOFI, but in this case they were not -- either ...
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America's Unique Literature is Self-Help

The idea of "bootstrapping" in statistics means re-using limited data in creative ways to draw a broader conclusion. In ordinary discourse, though, the phrase "pull yourself up by your bootstraps" refers to self-help. In my last post I wrote about the current Federal policy backlash against antidepressant medications; some of that antipathy may date from a uniquely American view of how people can improve themselves and their life circumstances. Jess McHugh's book Americanon : An Unexpected U.S. History in Thirteen Bestselling Books argues that self-help is actually the single more characteristic literary form generated by Americans over the history of the United States.  McHugh used publishing data to identify the books by U.S. authors with the largest circulation and the greatest public impact, from colonial times onward. Her results were not works of literature, science, or religion, but rather books that had a definite psychological slant. They included Poo...
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Blaming Prozac: The New Federal Attack on Antidepressant Medications

Antidepressant medications are one way to address symptoms of depression. They certainly aren't the only way, with psychotherapy having equivalent benefits in most cases, and exercise outperforming both of these options. I have also taken issue in the past with the way that antidepressants' beneficial effects have created a "brain disease" narrative around depression, which is about how we feel and behave more than it's about the way our brains are wired -- a functional problem rather than a structural one. Still, I recognize that antidepressants are lifesaving for many people, and I would never give blanket advice to suggest that people shouldn't take them. Some folks in the popular media right now are doing just that. The question of whether or not it was a good idea to take antidepressants was common in the early 1990s, when Eli Lilly's new medication fluoxetine (Prozac) had revolutionized the neurochemical treatment of depression. The book Listening ...
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Online Education, a Quarter-Century Later

I recently came across a book by Professor Gilly Salmon titled  eModerating: The Key to Teaching and Learning Online , published in the year 2000. I was just getting started as a college instructor that fall, and wouldn't dabble in online education for a few years more. Over the years I have attended my share of workshops about e-learning, online education, technology-assisted teaching, massive open online courses, micro-credentials, and whatever else was the buzzword of the day. A lot of what's in the book feels quaint at this point (teach your students that in online culture, capital letters suggest SHOUTING!). But there's a chapter toward the end that felt almost prophetic, in which the author identifies four potential futures for online teaching and learning: 1. On Planet Contentous , "content is king." Information flows from experts to novices, content-oriented online courses can have thousands of learners simultaneously (MOOCs, anyone?) and technology is ju...
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