An ever-present professional issue
The October article "Dealing with improper contact" addresses an important, ever-present yet often ignored professional issue: that patients can be dangerous, as evidenced by the murder of New York City psychologist Kathryn Faughey in 2008, though her killer was a colleague's ex-patient.
Even if physical assault is rare, the stress aroused by implicit threat can be considerable though most may derive less from the presenting situation and more from the therapist's sudden realization that they had failed to recognize earlier, subtle signs of danger, that they had made a mistake. A bit of advice: The angrier and louder the patient, the more softly the psychologist should speak.
Stanley Goldstein, PhD
Middletown, New York
Students under stress
The September "Students under pressure" article was enlightening and informative. There is no doubt that today's students have a multitude of problems to face that earlier generations could not even have imagined. Nevertheless, I hope those statistics somehow overstate the problem, for if not, the sheer magnitude of the numbers is alarming, suggesting a substantial portion of college-age students exhibit a level of emotional distress that borders on a crisis.
This article seemed to focus on traditional four-year colleges and universities primarily housing full-time students able to spend tens of thousands of dollars each year to attend. Despite the wide diversity of students today, this population still is predominantly white, 18 to 24 years old and from middle- to upper-class backgrounds that possess sufficient resources to assist or support their aspirations. As such, we know these students, by virtue of their backgrounds, will typically have access to numerous social networks, job opportunities and emotional support that often makes the critical difference between long-term success and failure.
Regrettably, those important benefits and resources are not available to most of their age-mate peers who are unable to attend college and therefore relegated to low-wage jobs, if they are working at all. Those working-class young adults represent only a small fraction of the invisible Americans who are also under significant emotional pressure, but unlike most full-time students, they have no support networks, no resource options, and little hope for changing their lives.
Thomas W. White, PhD
Overland Park, Kansas
The September article "Students under pressure" states that "specialized services and accommodations rarely exist" for college students with disabilities, including those with mental health issues.This is not entirely correct.
Under the 1990 Americans with Disabilities Act, all colleges and universities must provide students with disabilities with accommodations so that they can access the curriculum. However, unlike the requirements of special education law, which applies to K–12 students only, universities and colleges are not required to identify students who need support and are not required to provide services, such as tutoring or other supports for helping students complete work. To put accommodations into place, all colleges and universities must have a designated staff member. What is true is that the expertise of the staff member and the quality of services can vary widely, from a staff member who is the disability expert in name only, to a well-integrated disability support service, with staff available to meet with students regularly. Consequently, prospective college students with disabilities and their parents should carefully evaluate the quality of disability support, including mental health services, when selecting a college or university.
Robert L. Mapou, PhD
Silver Spring, Maryland
Reproducing results
The September "Reproducing results" article discusses an important aspect of research and what is being thought and done about it, but more needs to be said about the difficulties of replication. Replication of an experimentrequires a great deal of knowledge to accomplish and so is extremely difficult to achieve.
The selection/sampling of cases, inclusion and measuring of variables, control of experimental independent variables, attitudes of experiment operatives toward subjects and expected outcomes, data imputation and analysis methods must be identical. Anything less than this is not a replication and so its results cannot properly contest those of the original study, but only supplement them insofar as all the subsequent study's design and execution differences from the original are made clear. However, empirical studies of underspecified causal or predictive models cannot be replicated except by chance, and so long as a study results in residual/unaccounted for dependent variable variance it has relied on such a model.
Merton S. Krause, PhD
