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First Intervention Study Using TMT is Now Published: Exercise Sustainability in People with HIV

  This week I'm excited to share the results of a study that my colleagues and I just published in AIDS and Behavior . Here's the new article:  https://link.springer.com/article/10.1007/s10461-026-05317-w   The randomized trial in this paper is the first direct test of an intervention that was directly based on Two Minds Theory, and was conducted as part of a broader study on exercise to improve physical functioning in people with HIV (NIH grant # 1R01AG066562 , co-principal investigators Drs. Kristine Erlandson and Allison Webel). The first phase of that study involved patients exercising 3 times per week, with either continuous moderate-intensity exercise or high-intensity interval training (HIIT) exercise, for a total of 16 weeks. Then, at the end of the supervised exercise conditions, all patients in both groups were re-randomized to one of two behavioral intervention groups to help them maintain their exercise habits for another 3 months beyond the first exercise pha...
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Science and Faith: the Two Minds of Annie Dillard

The poet Annie Dillard died last week at the age of 81. She was a writer who applied deep theological reflection to her detailed observations of the natural world, with works that include novels, poems, prose, journalism, and autobiography, resulting in her receipt of a National Humanities Medal in 2015. Her writings have been compared to those of Thoreau, Woolf, and even William Blake. In reading the various tributes to Dillard's work, I recognized that she was another early influence on Two Minds Theory. In particular, her book Holy the Firm is  one that I first read as an undergraduate at Valparaiso University, and one that has remained my favorite piece of writing over the ensuing 33 years. This little book (only 66 pages in the first paperback edition) is classified under "Nature/Philosophy," and  often described as a meditation on theodicy, the problem of how a good God allows evil things to occur. And it is that, but not only that. It is also a book about writing...
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Measuring Creativity

  Creativity is a defining human characteristic, but it is also notoriously hard to pin down. I recently wrote about the benefits of diverse perspectives in solving real-world problems, which reminded me of the psychology literature on measures of creativity. We psychologists specialize in measuring characteristics of people that are hard to define, like intelligence or personality. But within the broad literature of psychological testing, creativity is a particularly tough nut to crack. Dr. Teresa Amabile of the University of Iowa pointed out that all studies of creativity begin with a significant "criterion problem," in other words, how do we define the thing that we want to study? To some extent, whether or not a work is "creative" is in the eye of the beholder. In my own Master's thesis on creativity, I operationally defined creativity as "being a student in art school," which I compared to "being a business student." But are artists i...
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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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