What Are the Confidentiality Rights of Collaterals in Family Therapy?

The privacy rights of collateral family members constitute one of the most complex ethical issues in the field of family therapy. The author opens with four case studies which illustrate some of the dilemmas. The opening section reviews the APA Ethics Code on this topic, followed by an in depth analysis of confidentiality issues in marital therapy and the special ethical dilemmas of high conflict, child custody cases. The author reviews the scant case law on this topic and closes with a set of best practices guidelines for the clinician.     

Gut or Game? The Influence of Moral Intuitions on Decisions in Video Games

Recent theorizing on the role of morality in media entertainment suggests morality serves as a guiding force in audience reactions to content. Using moral foundations theory as a base, research has found significant associations between moral salience and audience preferences for and responses to film and television varying in their presentations of morality. Our study extends this work by testing the same relationship in video games. Because a distinguishing factor between video games and traditional media is interactivity, our study focuses on how moral salience predicts decisions made in a video game. We find that increased moral salience led to a decreased probability of moral violations, while decreased moral salience led to an observed random (50%) distribution of violations. This finding was largely stable across different morality subcultures (German, United States) and age groups (adolescents and elderly), with deviations from this pattern explained by theory. We interpret this as evidence for a gut or game explanation of decision making in video games. When users encounter virtual scenarios that prime their moral sensitivities, they rely on their moral intuitions; otherwise, they make satisficing decisions not as an indication of moral corruption but merely as a continuation of the virtual experience.     

Rapprochement in Sight? Postmodern Family Therapy and Psychoanalysis

This paper explores aspects of the theory and practice of psychotherapy with the aim of identifying similarities in the approaches of both family therapists and psychoanalytic psychotherapists. The author calls for a dialogue between the disciplines, and makes specific reference to the potential value of this in relation to training and research.     

The Integrated Therapy of Family Members—A Case Report

Winnicott's concept of the “transitional space” is used in an effort to develop a conceptual unity between intra- and interpersonal dynamics. It is proposed that in their work together, the members of a therapy group develop a shared psychic “group space” derivative from the interaction of the “transitional space” of each, and within which the actual interpersonal transactions and influences take place. Possible underlying bases for such a theoretical concept are considered, as well as its implications for group therapy.     

The Role of the Family Therapist in Divorce: Benevolent Healer or Agent of Social Change?

Essay Review of:
The Dynamics of Divorce: A Life Cycle Perspective , F. W. Kaslow and L. L. Schwartz, New York: Brunner/Mazel, 1987.
Divorced Families: A Multidisciplinary Developmental View , C. R. Ahrons and R. H. Rodgers, New York: W. W. Norton, 1987.
The Difficult Divorce: Therapy for Children and Families , M. B. Isaacs, B. Montalvo, and D. Abelson, New York: Basic Books, 1986.     

Family Therapy — A Science or an Art?

Family therapy can be viewed as science and as art. Following leads provided by Gregory Bateson, this paper reflects on problems and promises inherent in both views.     

Family Therapy for the Historian?— The Case of William James

Family therapists disagree over the utility of historical reconstruction for treatment. Following either a behavioral or a psychoanalytic paradigm, theorists insist that history is irrelevant or essential to the treatment process. This paper demonstrates how a variety of family therapy concepts were used in his historical research into the life of the family of William James, the American psychologist and philosopher (1842–1910). This is offered as evidence both that family theory has a contribution to make to the writing of history and that the historical process is important to family therapy. It is suggested that clinical actuality calls forth interventions within both paradigms, often by the same therapist with the same family. The alternatives need not be mutually exclusive, though theory-building is clarified by talking as if the therapist were confronted by an either/or choice.     

Planned Straight or Biased to Be So? The Influence of Visual Feedback on Reaching Movements

Abstract

Behavioral studies consistently find that subjects move their hand along straight paths despite considerations that suggest reaches should be curved. Literature on this topic makes it clear that the experimentally displayed feedback influences how subjects reach. Could the standard visual feedback, a displayed cursor, explain the lack of path curvature in experimental results? To address this question, we conducted three experiments to examine reach behavior in the absence of the standard visual feedback. In the first experiment, we found significant increases in curvature as visual feedback was progressively extinguished across groups. A second experiment revealed that practiced reaches became curved after the standard visual feedback was removed. A final experiment found that subjects’ reaches made before and after a brief display of visual feedback were similar, indicating a preference for specific curved trajectories. Our results suggest that the consistently straight reaches often observed could be due to a bias to move the displayed cursor straight, which when removed reveal subject-specific preferences for reaches that are often curved.     

To Weight or Not to Weight? Balancing Influence of Initial Items in Adaptive Testing

It has been widely reported that in computerized adaptive testing some examinees may get much lower scores than they would normally if an alternative paper-and-pencil version were given. The main purpose of this investigation is to quantitatively reveal the cause for the underestimation phenomenon. The logistic models, including the 1PL, 2PL, and 3PL models, are used to demonstrate our assertions. Our analytical derivation shows that, under the maximum information item selection strategy, if an examinee failed a few items at the beginning of the test, easy but more discriminating items are likely to be administered. Such items are ineffective to move the estimate close to the true θ, unless the test is sufficiently long or a variable-length test is used. Our results also indicate that a certain weighting mechanism is necessary to make the algorithm rely less on the items administered at the beginning of the test. This research was partially supported by the NSF Grants SES0241020 and SES0613025. The authors thank the Editor, Associate Editor and two anonymous reviewers for their comments and suggestions. Send further information to Hua-Hua Chang, Department of Psychology, 603 E. Daniel Street, M/C 716, Champaign, IL 61820.     

How Do Master's Level Marriage and Family Therapy Students View Their Basic Therapy Skills? An Examination of Generic and Theory Specific Clinical Approaches to Family Therapy

This study examined the similarities and differences between marital and family therapy (MFT) students' beliefs about the importance of specific MFT skills, and the perceptions of experienced therapists in practice about the same skills. The data suggest overlap but not complete agreement between the perceptions of novice and experienced therapists regarding both generic and theory specific skills. Similarities and differences between these findings and earlier research about common factors in family therapy are addressed. Recommendations about clinical training that is not organized around traditional family therapy theories, but rather based on two trans-theoretical approaches to therapy labeled expert and collaborative are explored.     

The Role of Religion in Therapy: Time for Psychologists to Have a Little Faith?

The argument has been made that religious and spiritual (R/S) forms of treatment, or R/S adaptations of existing treatments, are an appropriate, culturally sensitive, and potentially efficacious method of intervention when working clinically with religious patients experiencing psychological, behavioral, or physiological dysfunction. The previous articles in this special series describe four such interventions designed for use with patients with particular presenting problems including serious mental illness, cancer, eating disorders, and scrupulosity. This article offers a brief historical presentation on the growth of interest in R/S in clinical psychology and behavioral medicine, with particular attention to the general issue of the role of values in therapy, and includes criticisms of integrating R/S in treatment. The difficulty of appreciating unique R/S perspectives and their relevance for particular clients is emphasized and the question of whether a “true” understanding of R/S beliefs necessarily leads to better health is examined. Each of the four therapies presented in this special series is individually analyzed, and it is clear that they offer sensitive and culturally relevant approaches to treating the various disorders, though areas of potential improvement or possible confusion are highlighted. Finally, the following are deemed essential if R/S-informed therapies are to impact the field and be appropriately introduced with clients: (a) training of future and current practitioners; (b) longitudinal research on R/S; (c) outcome studies of R/S interventions; and (d) adequate funding for the achievement of these goals.     

Creating “Maneuvering Room”: A Grounded Theory of Language and Influence in Marriage and Family Therapy

Influence in psychotherapy has been described as a characteristic of the therapist, a characteristic of the therapeutic relationship, and a negotiated process. This study combines grounded theory and task analysis to explore language patterns in facilitating change in family therapy. Thirty-one episodes of therapy were analyzed, resulting in the emergent concept of creating maneuvering room. Therapists introduce uncertainty into clients beliefs about problems then offer new ways of defining problems by speaking from three dimensions: therapist as expert or non-expert, therapist as participant or observer, or family members experiences as similar or different. The findings of this study support a possible common factor in family therapy.     

Right to Die or Duty to Live? The Problem of Euthanasia

Argument about euthanasia in Australia intensified following the world's first legal euthanasia death of Bob Dent under the Northern Territory's short-lived Rights of the Terminally Ill Act 1995. This paper takes stock of the implacably opposed positions on euthanasia following Bob Dent's death, which provides a focus for the controversy, and identifies the key doctrines which separate adversaries in the euthanasia debate and their associated incommensurable intuitions.     

A Case of Child and Family Therapy: Is Anger Permissible in This Home?

This article illustrates the impact of a peer supervision group on the treatment of an Orthodox Jewish child and her family system. Examples of treatment difficulties encountered when Orthodox therapists treat Orthodox patients are also presented. It highlights the use of a peer supervision group as a means to manage some of these treatment difficulties.     

Family Therapy in India: A New Profession in an Ancient Land?

This paper examines the need for family therapy in India and its evolution as an integrated academic discipline and widespread form of clinical practice. Included is a discussion of the numerous factors placing Indian families at risk today, both common and more serious child, marital, and family difficulties, the current status of mental health services and minimal emphasis on family-based treatment, and the potential benefits of family therapy to such a radically diverse and rapidly changing society. Targets of and settings for family therapy training are highlighted, and a brief outline of a training-the-trainer approach is provided.     

What Makes Susie Cry? A Symptom-Context Study of Family Therapy

The aim of this investigation was to examine the context of recurrent crying episodes during family therapy sessions. We tested the relative contribution of social versus individual intrapsychic variables within a 10-session, videotaped, structural family therapy. Segments of therapy before crying episodes when compared with control (non-crying) segments were found to have higher levels of the following variables: involvement with others in the room, rejection, and concern about supplies. Two family variables were also higher before crying episodes: family discussion about patient, and patient receives hostility. A stepwise discriminant function analysis using these variables indicated that family discussion about the patient was most important in signaling onset of crying. The results are discussed in terms of individual and family theories of symptom formation as illuminated through this case study.     

The Role of Family Affect in Juvenile Drug Court Offenders’ Substance Use and HIV Risk

Family-based interventions targeting parenting factors, such as parental monitoring and parent–child communication, have been successful in reducing adolescent offenders’ substance use and delinquency. This pilot, exploratory study focuses on family and parenting factors that may be relevant in reducing juvenile offenders’ substance use and sexual risk taking behavior, and in particular examines the role of family emotional involvement and responsiveness in young offenders’ risk-taking behaviors. Participants included 53 juvenile drug court offenders and their parents. Results indicate that poor parent–child communication is associated with marijuana use and unprotected sexual activity for young offenders; however, family affective responsiveness is also a significant unique predictor of unprotected sexual activity for these youth. Findings suggest that interventions focused on improving parent–child communication may reduce both marijuana use and risky sexual behavior among court-involved youth, but a specific intervention focused on improving parents and young offenders’ ability to connect with and respond to one another emotionally may provide a novel means of reducing unprotected sexual risk behaviors.