The family experience of "sudden health": the case of intractable epilepsy

This article reports the experience of "sudden health" among six families who participated in an exploratory qualitative study of families with a member who elects to have corrective surgery for intractable epilepsy. Families were interviewed pre- and post-surgery (6-8 months) and the interviews were analyzed using a constant comparative methodology. Findings indicated that (1) families were organized in two primary ways (nesting and crisis) to deal with epilepsy and the aftermath of surgery and (2) "sudden health" had differing effects on these families depending on their organizational style, emotional communication process, and developmental dynamics.     

"Living with" the past: coping and patterns in families of Holocaust survivors

This exploratory study looks at how families of Holocaust survivors work through the traumatic past by considering the coping patterns adapted by family members. Life-story interviews (Rosenthal, 1993) with 57 individuals from 20 families, in which there were two to three generations, were used in order to learn about the significance they attach to the Holocaust past. The interviews were analyzed using Rosenthal's methods and Danieli's (1988) typology of post-war adaptation (victim families, fighter families, those who made it, and numb families). Results showed that in order to differentiate between the coping styles exhibited by the families, two new categories had to be added to Danieli's typology. These were entitled "life goes on" and "split families." It was concluded that survivor families exhibit heterogeneity in the ways in which they cope with the Holocaust past.     

Qualitative Cancer Genetic Counseling Research, Part II: Findings from a Exploratory Ethnographic Study in a Cancer Clinic

This is a report of the preliminary findings of a brief exploratory ethnographic study in a cancer diagnosis and treatment clinic. The main research purpose was to explore the meaning of cancer and cancer treatment to patients themselves and to their relatives and close friends. The methods are described in detail in a paper focusing on the experiences of being a novice ethnographer (Peters et al. (2001) J Genet Counsel 10(2):133–150.). The preliminary results of this exploratory fieldwork indicate that the experience of attending a cancer treatment clinic for evaluation and/or treatment is a complex social, emotional as well as medical process for patients and families. Themes with relevance to genetic counselors that emerged from this early observation period included ideas about causes of cancer, the complex nature of families and kinship, coping and support, use of food, and healing. These initial findings have implications for genetic counseling practice and hopefully will stimulate more qualitative social and behavioral research in cancer genetic counseling.     

Family Sculpting in Preventive Work with "Well Families"

This paper will describe an experimental community project aimed at "well families". The program was designed to be preventive by providing service to families before their problems escalated into crisis proportions. It emphasized an educational rather than treatment bias; this orientation forced us to expand concepts, experiment with new techniques, and re-evaluate our ideas on how families change. Of particular importance to us was the emphasis on behavioral change rather than intellectual insight. In the course of this work, family sculpting came to be an increasingly valuable tool.     

Change: How do we recognize it?

The paper seeks to examine the working assumptions that guide us as therapists engaged in the attempt to facilitate change in families. It summarizes a piece of preliminary research based on the responses of a group of therapists working in different agencies. A questionnaire on change was developed and given to the therapists followed by a group discussion.
The results suggest that therapy teams, and families, have common sense ideas about:

• the beginning, and end of a period of change;

• types of change—those falling into four categories; of behavioural, structural, communication and experiential.

Our results suggest that difficulties in therapy may be associated with a failure amongst the therapists in a team to negotiate their mutual assumptions about change. In addition the process of therapeutic change is seen as involving a negotiation between the family and the therapists about what will count as change.
The data were gathered from a group of therapists attending a local meeting of the Association for Family Therapy in Plymouth.     

Pathways to problems – an exploratory study of how problems evolve vs dissolve in families

A social constructionist and a systemic lens are combined to consider the nature of the development of problems in families. An exploratory qualitative study is presented in which families were invited to discuss their constructions of the onset of difficulties and their subsequent progression. Qualitative data are presented from two groups of families: where there had been spontaneous recovery (SR) as opposed to where the problems were still current (PC). The findings suggest that a combination of factors, including helpful inputs in the form of practical assistance and non-pathologizing definitions can help avert descent into pathology. However, the ability of families to recognize and utilize positive inputs also appeared to be related to their available resources, including their 'spare emotional capacity' . The findings lend some weight to the clinical view that early validation and support is essential for families to help them to utilize their natural self-healing capabilities.     

The child abusing family: I. Methodological issues and parent-related characteristics of abusing families

Abstract

The physical abuse of children by their parents is a family matter and should be viewed within the context of the family unit. Unfortunately, few child abuse studies have directly examined the family unit. Rather, most studies focus on characteristics of individual members of abusing families or on dyadic relationships within abusing families. Therefore, the present paper examines the family-related variables that might contribute to child abuse. This review is divided into two parts. Part I discusses methodological considerations and parent-related aspects of abusing families, including: characteristics of abusing parents, childhood experiences of abusing parents, marital relationships of abusing parents and the perceptions and expectations that abusing parents have of their abused children. Part II of this review, which will appear in a later issue, will cover child-related aspects of abusing families, parent-child interactions in these families, environmental conditions associated with child abuse and typologies of abusing families.     

What Can We Learn from the Study of Mexican‐Origin Families in the United States?

Mexican‐origin families are a large and rapidly increasing subgroup of the U.S. population, but they remain underrepresented in family scholarship. This paper introduces a special section of four papers on Mexican‐origin families designed to contribute to the advancement of research on how cultural, family, and gender socialization processes unfold across key developmental periods and life transitions in this cultural context. Two longitudinal studies of Mexican‐origin families provided the data for these four papers: (a) The Juntos Project, an 8‐year longitudinal study of mothers, fathers, and adolescent sibling pairs in 246 Mexican‐origin families; and (b) The Supporting MAMI Project, a study following 204 adolescent mothers and their mother figures from the third trimester of pregnancy through their young children's 5th birthdays. In this introductory paper, we highlight four themes, including (a) differential acculturation and reciprocal socialization, (b) interdependence in families, (c) the intersection of culture and gender, and (d) methodological issues. We end with suggestions for future research.     

Divorce Terminable and Interterminable: A Psychoanalytic and Interdisciplinary Approach

Psychoanalytic therapy of divorce studies positive and negative aspects of couples' bonds, focusing on the guilt and narcissistic wounds of the multiple losses. Interactionally structured aspects of identity are especially difficult to mourn in the interminable divorces where separation is incomplete. A case demonstrates work with families to transform negative links, often including consultation with the legal system and work with the children.     

A "unity assumption" does not promote intersensory integration

An account of intersensory integration is premised on knowing that different sensory inputs arise from the same object. Could, however, the combination of the inputs be impaired although the "unity assumption" holds? Forty observers viewed a square through a minifying (50%) lens while they simultaneously touched the square. Half could see and half could not see their haptic explorations of the square. Both groups, however, had reason to believe that they were touching and viewing the same square. Subsequent matches of the inspected square were mutually biased by touch and vision when the exploratory movements were visible. However, the matches were biased in the direction of the square's haptic size when observers could not see their exploratory movements. This impaired integration without the visible haptic explorations suggests that the unity assumption alone is not enough to promote intersensory integration.     

Religion and Family Relational Health: An Overview and Conceptual Model

This paper presents a review of research addressing religion and family relational health. Strengths of the extant data include the correlation of three dimensions of religious experience (religious practices, religious beliefs, and religious community) with certain aspects of mother–child, father–child, and marital relationships and specific connections between the three dimensions of religious experience and family relationships are identified. Key weaknesses in the research at present include a paucity of research examining the hows, whys, and processes involved behind identified religion–family correlations and a lack of data on non-nuclear families, families of color, interfaith families, and non-Christian religions including Judaism and Islam. Implications for clinical practice and recommendations for future research are offered. Loren Marks is an Assistant Professor of Family, Child, and Consumer Sciences in the School of Human Ecology at Louisiana State University. He and his research collaborator, David Dollahite of BYU, have conducted extensive qualitative research with over 125 Christian, Jewish, Mormon, and Muslim families to examine the interfaces between religion, individual development, and family relationships.     

Confirming satisfaction as an attitude within the service‐buying process

This paper presents research that uses cognitive and affective semantic differential scales to construct an attitude measuring instrument to be used in the services domain in the context of long applications to buy a service. The scales measure ‘Attitude to the Application Process’ (AAP) which represents satisfaction, as an internal ‘buying process’ attitude, which moderates the buying intention. Data collected over a three‐year period between 1996‐9, was analysed using exploratory and confirmatory factor analyses. The results provide evidence of a robust and useful cognitive scale. Although there were anomalies in the exploratory and confirmatory analysis of the affective scale, a robust scale is presented which represents either one or two factors. The whole measuring instrument of 14 items was developed as a means to access applicant attitudes during the application process to university — an extended and extreme application situation for first‐time consumers. The results identify that the instrument is sound and can be used in its original or modified form, depending on the context of the service‐process monitoring situation. The scales represent aspects of attitude not dealt with extensively in the literature and measure the perception of the application process as simple, open, friendly and helpful. These aspects of satisfaction mirror three attributes of service quality: assurance, responsiveness and empathy identified in previous research. Copyright © 2001 Henry Stewart Publications.     

The Physical Appearance Perfectionism Scale: Development and Preliminary Validation

Eight studies with data from 2316 students are presented describing the development and preliminary validation of the Physical Appearance Perfectionism Scale (PAPS), a brief measure with two subscales: Worry About Imperfection and Hope For Perfection. Results from exploratory and confirmatory factor analyses confirmed the measure’s two-dimensional structure. Moreover, correlation analyses provided first evidence for the two subscales’ differential validity: Worry About Imperfection showed negative correlations with positive self-perceptions of one’s appearance (e.g., appearance self-esteem) and positive correlations with maladaptive concerns aspects of perfectionism, physical appearance concerns (e.g., body image disturbances), and body weight control whereas Hope For Perfection showed positive correlations with positive striving aspects of perfectionism, positive self-perceptions, and impression management. In addition, all PAPS scores showed high reliability (Cronbach’s alpha) and temporal stability (test-retest). Overall the findings suggest that the PAPS is a reliable and valid instrument to assess positive and negative aspects of physical appearance perfectionism.     

Engaging “Resistant” Families in Treatment

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging “resistant” families. ¹ 1 The first paper in this series, authored by J. M. Van Deusen, M. D. Stanton, S. M. Scott, and T. C. Todd, is entitled “Engaging “Resistant” Families in Treatment: I. Getting the Drug Addict to Recruit His Family Members” and appeared in the International Journal of the Addictions 15 (7): 1069–1089, 1980. A revised and expanded version of Part II is presented in M.D. Stanton, T. C. Todd, and Associates, The Family Therapy of Drug Abuse and Addictions New York, Guilford, in press.
Part II presents 21 principles and a number of techniques and strategies that have been developed for successfuly recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided. We conclude that the engagement process requires a revision in therapeutic philosophy, since such families are often desperately in need of help but are unavailable unless therapists make a special effort to reach them.     

Spouse and Family Functioning Before and After a Marine’s Suicide: Comparisons to Deaths by Accident and in Combat

The impact of service member suicides on families is not well understood. Civilian studies have demonstrated that family survivors of suicide deaths experience complicated grief, feel guilt and shame, and often do not receive sufficient social support. In this exploratory study, spouse survivors of Marines who died by suicide (N = 17), accident (N = 19), and in combat (N = 34) retrospectively reported on their immediate pre- and postmortem and current personal and family functioning. Nonparametric analyses revealed that several between-group differences existed. Observation of the means suggested that the spouses and families of Marines who died by suicide exhibited significantly poorer pre- and postmortem functioning compared with those whose spouses died in combat. Specific challenges included low family cohesion, high family conflict, perceived stigma, and shame. There were no differences in current spouse or family functioning, and there was weak evidence for posttraumatic growth among surviving spouses of those dying by suicide. These results should be considered preliminary and interpreted with caution given several methodological challenges.     

The Unencumbered Child: Family Reputations and Responsibilities in the Care of Relatives with Alzheimer's Disease

Using a grounded theory methodology in exploratory interviews with noncaregiving and caregiving adult children, differences were found in their experience of burden, their focus, their suffering, and their sense of responsibility. Childhood reputations appeared to follow siblings into adulthood, and they describe finding their adult positions in the family clearly circumscribed and entrenched because of family legacy. Children who were in some way different and excused from family responsibilities in childhood because they were, for example, “spoiled,” a “problem child,” the “intellectual,” or “flaky,” appeared to be unencumbered as adults when faced with caregiving responsibilities for a relative with Alzheimer's disease. Although these uninvolved and unencumbered children seemed to take less caregiving responsibility, they describe their loss and suffering in relation to a loss of identity and selfhood, whereas other children describe their burden and the overwhelming pulls and demands made on them. These preliminary findings suggest the need for systematic scientific inquiry about families, including multiple relatives, family history, impact of family-of-origin legacy, family reputations, and family negotiation patterns.     

Beneficial factors in family discussion groups of a psychiatric day clinic: perceptions by the therapeutic team and the families of the therapeutic process

This paper reports a pilot investigation of the perception of helpful events by the therapeutic team and the families in two family discussion groups (FDGs) of a psychiatric day clinic. All participants of the FDG, including therapists and observers, filled in questionnaires measuring events helpful for the individual, for the family and for the group after each FDG session. The results showed that the therapeutic team and the families diverged in their overall perception of which factors were important in family discussion group therapy. The therapeutic team saw the relational climate and the structural aspects of the group (including group involvement and support from the group), and specific therapeutic interventions as more helpful than the families. The process aspects in the group members (including the experiencing of communality and gaining insight) were, on the other hand, more frequently mentioned by the families than by the therapeutic team. The clinical implications of these findings and suggestions for future research are discussed.     

The Emotional Development Scale: Assessing the Emotional Capacity of 4–12 Year Olds

The practice of assessing children’s emotional development based on a theoretical foundation of attachment theory, developmental psychology, and brain research is fast developing within the field of clinical psychology and family social work. The Emotional Development Scale (EDS) has been developed to assess the current emotional functioning level of 4–12 year olds within the theoretical framework of neuroaffective developmental psychology. Included in the pilot study were eight family treatment centers in Denmark, with 36 families participating. The psychometric investigation included analyses of interrater reliability, test-retest reliability, and internal consistency, while construct validity was analyzed by correlating EDS results between referred and nonreferred groups. The analysis between nonreferred and referred groups was based on the data from the empirical study and a preliminary ad hoc sample from Hogrefe Ltd. (n = 213). We concluded the EDS appears to be a reliable and partially valid tool that could aid in assessing the emotional development of 4–12 year olds. Further research on psychometric properties and clinical application of EDS is needed.     

Cognitive Abilities As Expressions Of Three "Ways Of Knowing"

Factor analytic studies suggest that there are six replicable second order cognitive factors. These six factors lend themselves to being interpreted as aspects of Royce's (1964) three "ways of knowing." This view provides a unified explanation of the second and third order factors. We hypothesize that each second order factor represents either the number of cognitive schemata of a particular type that a person possesses or the quality of these schemata, and the types of schemata are linked to "ways of knowing." The division of second order factors into qualitative and quantitative aspects, with the qualitative aspects being more subject to deterioration with age, and the quantitative aspects more trainable and subject to personality influence, provides an avenue for linking cognitive abilities to the other personality traits. The theory also resolves several theoretical problems concerning cognitive abilities, including distinguishing aptitudes from achievements, measuring creativity, and determining the relationship between rote memory and intelligence.