Family treatment of an obsessive-compulsive child: a case report

This paper presents a family therapy approach to the treatment of an obsessive-compulsive child. Psychodynamic, behavioral and family therapy approaches to the etiology and treatment of this dysfunction are described briefly, and a detailed case report of a 15-session treatment utilizing behavioral interventions designed to change the family context is presented. Various procedures for dealing with the obsessive-compulsive behavior have been reported in the literature, including eliminating it directly by interruption or ordeal and modifying it. In this case, the author proceeded by ignoring the compulsive behaviors and concentrating on more functional ones using a paradoxical charting intervention. At one-year follow-up, the child was symptom free. Relationship factors, technical interventions, and stylistic aspects of the therapy are discussed, and the importance of rapid symptom alleviation in these children is underscored.     

Family therapy with deaf persons: the systemic utilization of an interpreter

This paper discusses the theory and practice of providing family therapy to families in which there are hearing parents and at least one Deaf child, particularly regarding the optimal utilization of an interpreter. The therapist must be knowledgeable about the psychosocial effects of deafness, the cultural aspects of deafness, and preferably be able to use American Sign Language and Signed English. The therapeutic benefit of utilizing an interpreter extends far beyond simply facilitating communication between each family member whose primary-language is either spoken English or Sign Language. The presence of an interpreter helps the therapist to modify family rules that deny the implications of deafness and prohibit the use of Sign Language, to modify the balance of power in the family, and to encourage participants to exhibit the ego defense mechanisms of projection and transference. The family therapist can utilize those subtle yet profound influences to therapeutic advantage.     

Family therapy and anthropology: a case for emotions

The idea that emotions are socially constructed challenges traditional views in both family therapy and anthropology and also opens the possibility for further collaboration. This paper reviews the traditional position of orthodox family therapy theory with respect to motivation and emotions. It argues that a social constructionist position can build on original family therapy insights about the connectedness of family members and offer a view which transcends mind-body dualism. Bateson's concept of ethos is seen as a forerunner of this view and, with the increasing interest in meaning and cross-cultural issues, Bateson's ideas deserve renewed attention. Implications of a social constructionist view of emotions for family therapists are outlined.     

Family therapy as a treatment for children: a critical review of outcome research.

The value of family therapy as a treatment for child psychopathology is considered by reviewing pertinent outcome research. Fourteen studies that met three criteria are included in the review: (a) a child or adolescent was the identified patient or referral; (b) therapy included at least one parent and the child; and (c) outcome was evaluated in terms of the child's symptoms. There are major shortcomings in most of the available data, with only two well-controlled studies. Some empirical evidence does exist that family therapy is an effective treatment for children; the data from studies of adolescents are especially encouraging. However, insufficient data are available for comparing the relative merits of conjoint family treatment and individual child therapy. If the value of family therapy as a treatment alternative or, ideally, as the "treatment of choice" for a referred individual child is to be established, more and better controlled comparative outcome studies will be necessary. Suggestions for future research are presented emphasizing the need for a developmental perspective by recommending, for example, the use of factorial designs in which the intervenaction of treatment and age can be analyzed.     

Subcortical anarthria: a case report.

A 56-year-old right-handed male with a history of hypertension and diabetes presented two episodes of stroke: The first affected territory was the left anterior coroidal artery (capsular and paracapsular infarcts at the level of the genu and posterior arm of the internal capsule) and the second was the right thalamus, due to a hematoma. Following the first stroke, the patient developed severe dysarthria and after the second stroke remained anarthric. The pathophysiology of the disorder is discussed, and the role of the left and right thalamus as far as speech is concerned is reviewed.     

Neural substrates for verbal working memory in deaf signers: fMRI study and lesion case report

The nature of the representations maintained in verbal working memory is a topic of debate. Some authors argue for a modality-dependent code, tied to particular sensory or motor systems. Others argue for a modality-neutral code. Sign language affords a unique perspective because it factors out the effects of modality. In an fMRI experiment, deaf participants viewed and covertly rehearsed strings of non-sense signs; analyses focused on regions responsive in both sensory and rehearsal phases. Compared with previous findings in hearing subjects, deaf subjects showed a significantly increased involvement of parietal regions. A lesion case study indicates that this network is left-dominant. The findings support the hypothesis that linguistic working memory is supported by modality-specific neural systems, but some modality-neutral systems may also be involved.     

Family therapy with adolescent offenders: A collaborative treatment strategy

Abstract

An intervention strategy is presented which can be used with families of adolescents who continue breaking the law despite improvement of family functioning during therapy. The strategy emphasizes collaboration between the therapist and juvenile justice system in stopping the child's law-breaking behavior in the shortest amount of time. The treatment strategy is suggested as a specific intervention to be used only when conventional family therapy strategies have failed to promote the cessation of the adolescent's law-breaking behavior. As such, it is suggested as a strategy to be used in conjunction with family therapy rather than as a comprehensive treatment approach in itself.