A survey of referral activities of agencies serving adolescents

The referral activities of 373 agencies (38.4% of the sample originally polled) are presented with regard to health care, educational, and social services for teenagers residing in a midwestern metropolitan area. Approximately 66% of the responding agencies receive referrals from without and 87% make referrals to other organizations, with counseling and psychiatry, family planning, and general medical care being the most commonly sought services. Social service agencies had the highest volume of referrals and hospitals the lowest. The results of the survey are discussed in terms of the official recommendations made for coordinated services for teenagers, predicted cutbacks in preventive services, and the special needs of adolescents.     

A follow-up investigation of families referred to outside agencies

A follow-up study was conducted to determine the outcome of 254 referrals made by 47 school psychologists in New York and New Jersey. The referrals represented randomly selected cases in which the recommendation was made to the families of elementary school childred to use service external to the school setting. Evaluation of referral outcome was determined in light of the reason prompting the referral recommendation. Explanations for the outcome of referrals summarized in this investigation were advanced and the limitations of this study noted.     

A family of differentiation indices

A general class of differentiation indices is introduced for profiles of scores. Their ordinal properties and an application to Holland's classification system are examined. Comparison with other suggested indices is performed both theoretically and empirically.We are grateful to Professors J. Rayman and J. L. Holland for an interesting discussion. We would also like to thank Vera lachan for suggesting the problem.     

A feminist critique of family therapy

This paper is a feminist critique of traditional family therapy considering the cybernetic epistemology underpinning it as a particular way of seeing the family. The political implications of this way of seeing d be considered in tern of structural inequalities with a preference for, the intergroup perspective. There will be a close examination and discussion of the one parent family structure. The discussion will then move one a practical evaluation of the ecosystemic view of helping families, in particular single parent families.     

A three-year follow-up of family therapy

A 3-year follow-up of a family therapy focusing on adolescents was done. Twenty-four of 28 families were contacted by telephone interviews with the mothers. Nine variables were assessed with a trend shown toward the deterioration of previously superior effects of short-term family therapy with 57% of the family therapy group identified patients versus 20% of the individual therapy group identified patients having been rehospitalized by the end of the 3 years since the original (3 month) follow-up. Thus, the longer-term finding suggests a superior effect of individual therapy over family therapy, although this conclusion must be provisional in the light of limitations in the research method used and/or chance factors.Our interest in this brief report is to call attention to the critical nature of the time factor in follow-up studies, as most of those currently available have been limited to follow-up periods of one year or less.     

A cross-cultural study of family functioning

The Family Assessment Device (FAD) was used to compare patterns of family functioning in two cultural settings, North America and Hungary. The sample size consisted of 95 nonclinical North American families and 58 nonclinical Hungarian families. No cross-cultural differences were found in the families' general functioning nor in their affective involvement or affective responsiveness as measured by the FAD. Hungarian families, however, perceived their functioning as significantly better than the North American families in problem-solving and in communication. North American families rated themselves significantly better than the Hungarians in setting family rules and boundaries and in meeting their family responsibilities. Results from this study suggest that cultural values can affect a family's functioning and that differences in areas of family functioning can be captured using the FAD. A discussion of broad societal values of the two cultures was used to interpret the contrasting patterns of family functioning.Cross-cultural studies serve many purposes. In general they provide knowledge about the different cultures under investigation. As such, they broaden and enrich our perspectives of ourselves and the world around us. More specifically they highlight similarities and differences across cultures, information that can be helpful in further refining our understanding of the impact of diverse and varying socio-political forces.A topic of particular interest to family therapists and researchers is family functioning in different cultural settings. In spite of continuing research in this area, few studies examine cross-cultural patterns of family interactions and even fewer do so with instruments specifically designed to assess family functioning.From a family perspective, particularly looking at pathology in family functioning, cross-cultural comparisons can be used to highlight areas of dysfunction common to families irrespective of the cultural context. From a cross-cultural perspective, family comparisons can be used to point out the cultural effects and emphases given to different dimensions of functioning within a common system (i.e., the family unit).Both conceptual and methodological problems have contributed to shortcomings in previous cross-cultural studies (Fabrega, 1974; Kleinman, 1987; Flaherty et al., 1988; Rogler, 1989). A basic criticism of such studies has been the assumption that meanings and values in one culture are equivalent to those in another.Another issue, which is particularly pertinent to our study, is the use of an instrument which is developed in one culture and administered in another cultural setting. A potential problem this raises is inferring cultural differences between groups when the translated and the original instruments are not actually comparable in meaning. In fact, one objective of the study was to see whether our own self-report measure of family functioning, the Family Assessment Device (FAD, Epstein et al., 1978, 1983), could be successfully used in another cultural setting.The following report is part of a larger research project, conducted in 1986–87, that compared depressed and nonclinical families across two cultures. The findings presented here are comparisons between nonclinical Hungarian and nonclinical North American families. In our earlier study differences in family interactions between clinically depressed and nonclinical families were evident in both cultural settings (Keitner et al., in press). It was not clear, however, if significant cross-cultural differences in family functioning would be found for the normal group of families and, if so, how these would differ from their ill counterparts. Inclusion of the normal families thus served two purposes, as controls in the larger study to test within cultural differences and as comparison groups in a separate analysis to test between cultural differences.A specific objective of this study was to contrast patterns of perceived family functioning in nonclinical Hungarian families and North American families. Another objective was to determine if the Family Assessment Device (FAD), a self-report measure of family functioning, could be successfully used in different cultural contexts. Hungary was chosen as an appropriate country of study for several reasons. It is at the crossroads of East and West, sharing enough similarities with western culture to validate comparisons, yet different enough in both its cultural and sociopolitical system that some differences could be expected to emerge. Because it is likely that the Hungarian social system is less familiar to readers than that of North American, the results are discussed with particular reference to Hungary.We would like to thank Drs. J. Furedi and T. Kurimay for help in translating the Family Assessment Device and Professors J. Szilard and Muszong-Kovacs for their support of this study. This work was supported in part by the Firan Foundation.     

The psychosomatic family model. A critical analysis of family interaction concepts

The psychosomatic family model of Minuchin and his colleagues is one of the best known and influential viewpoints in the field of family therapy. This article critically analyses this model and related concepts, focusing on the lack of clear definitions, especially with regard to the interactional concepts: enmeshment, rigidity, overprotectiveness, and lack of conflict resolution. Each concept is discussed, concluding with the recommendation of a new definition, so that the model can be empirically verified. The authors suggest that Minuchin's model can be reduced to three fundamental interactional dimensions : the intensity of intrafamilial boundaries, the degree of the family's adaptability, and the family's way of handling conflicts. A research method is presented in which the way of assessing these interactional dimensions is demonstrated.     

A survey of the use of facilitated communication in community agencies serving persons with developmental disabilities

Service providers to individuals with developmental disabilities at seven North Dakota agencies were surveyed on their current and past use of facilitated communication (FC). Perceived validity and effectiveness of FC were also assessed. Seventeen percent of the 177 direct care and supervisory staff surveyed reported that they had never heard of FC, 36% were aware of but had never used FC, 28% had previously used FC, and 18% currently used the technique despite overwhelming experimental evidence that FC is not a valid means of communication for people with disabilities. The results indicated that respondents who had previously used FC, but did not do so currently, gave it the lowest ratings of validity, usefulness, and likability, while current users gave FC the highest ratings. Current users had the fewest years of experience in the field of developmental disabilities. The majority of current users said guardian approval should not be required prior to the use of FC, whereas the majority of past users and non-users said that guardian approval should be required. © 1998 John Wiley & Sons, Ltd.     

A guide to family/school interventions for the family therapist

When presented with a behavioral problem or symptom expression that involves two systems, such as a serious school-related problem, the therapist needs to design an approach that will intervene effectively and expeditiously in both systems. This paper offers a guide to stages of problem escalation and therapeutic intervention that is intended to aid the problem-solver's thinking processes in approaching a troubled situation that involves two systems, the school and the home.     

The nonuse of psychological research at two federal agencies

In 1994 the Government Accounting Office (GAO) issued a report critical of some features of the proposal review processes at the National Science Foundation and the National Institutes of Health. I provide two examples of procedures the agencies could have adopted to address the GAO's criticisms. I also relate the history of the two agencies' reluctance to use the psychological research literature to guide them as their new review procedures were instituted. Finally, I enumerate possible reasons for the agencies' decision not to follow or even test suggestions based on the judgment and decision-making research literature.     

Intelligent management of intelligence agencies: beyond accountability ping-pong

The intelligence community (IC) is asked to predict outcomes that may often be inherently unpredictable-and is blamed for the inevitable forecasting failures, be they false positives or false negatives. To move beyond blame games of accountability ping-pong that incentivize bureaucratic symbolism over substantive reform, it is necessary to reach bipartisan agreements on performance indicators that are transparent enough to reassure clashing elites (to whom the IC must answer) that estimates have not been politicized. Establishing such transideological credibility requires (a) developing accuracy metrics for decoupling probability and value judgments; (b) using the resulting metrics as criterion variables in validity tests of the IC's selection, training, and incentive systems; and (c) institutionalizing adversarial collaborations that conduct level-playing-field tests of clashing perspectives.     

A systemic view of family therapy ethics

A critical review of the literature on family therapy ethics is used to develop the proposition that a more systemic analysis is needed, one that includes the levels of therapist and society as well as patient (family). These ideas are discussed through reexamining the issues of family secrets, therapist deceptiveness, and therapist advocacy of personal (feminist) values.     

A listing of therapists doing family therapy

Pastoral Psychology -     

A typology of family social environments.

A sample of 100 families measured on ten dimensions of their social environments was subjected to cluster analysis to develop an empirically based taxonomy of families. Six distinctive clusters of families were indentified: Expression-Oriented, Structure-Oriented, Independence-Oriented, Achievement-Oriented, Moral/Religious-Oriented and Conflict-Oriented. The clusters showed systematic differences in background characteristics such as size, ethnic minority composition, drinking patterns, and family disturbance and incongruence. Some evidence that certain clusters of families are composed of different sub-clusters was presented. An empirically derived taxonomy of the social environments of families may help to understand how different family environments are linked to different family outcomes.