A beginner's guide to the problem-oriented first family interview

The large volume and diversity of family therapy resources can often confuse trainees who are in need of more abbreviated guidelines for managing their clinical responsibilities. This paper presents a structured outline of a problem-oriented first family interview for the family therapy supervisor and the beginning family therapist. We view the first interview as an integrated process including the important tasks preceding and following the initial family meeting. After the goals that shape the work of the first interview are described, a step-by-step guide to the twelve phases of the interview is presented: telephoning; forming hypotheses; the greeting; the social phase; identifying the problem; observing family patterns; defining goals; contracting; checklist; revising hypotheses; contacting the referral person; and gathering records. This approach to the first interview integrates a variety of structural and strategic procedures. The guide, intended for use in conjunction with close supervision, may serve as a foundation on which beginning therapists can build their unique styles.     

Reflex responses of human lip muscles to mechanical stimulation during speech

The role played by reflex pathways in the production of movement has been a significant issue for motor control theorists interested in a wide variety of motor behaviors. From studies of locomotion and chewing, it appears that gains in reflex pathways can be altered so that activity in these pathways does not produce destabilizing responses during movement. In speech production, recent experimental evidence has been interpreted to suggest that autogenetic lip reflexes (perioral reflexes) are suppressed during sustained phonation or speech production. The present study was conducted to assess the effects of phonation, direction of movement, and ongoing speech production on reflex responses of lip muscles. The present results suggest, in contrast to earlier work, that this reflex pathway is not suppressed or absent because the amplitude of the observed response depends upon the activation levels of the various muscles of the lower lip and, therefore, indirectly on the nature of the gesture the subject is instructed to produce.     

Infant hypotonia, obesity, hypogenitalism and oligophrenia--new viewpoints on the etiology and symptoms of Prader-Willi syndrome

We present four cases of Prader-Willi syndrome. Two of them have an abnormality of a chromosome 15, the other both show different chromosomal abnormalities. Translocations or deletions were found recently in the bands 15q11/12 in about 60% of the cases of Prader-Willi syndrome. The consequences for diagnosis, symptomatology and genetic counselling of the syndrome are discussed.     

The time it takes to imagine1

Stanley and Furedy (1966), using the paired-comparisons technique, reported that under conditions where size constancy held, Emmert’s law failed as distance increased beyond 90 in. Experiment 1, designed to check this report with a shorter-duration induction flash, did not yield 90 in. as the point of failure. However, although complete size constancy for direct images was again obtained, the results did not unambiguously suggest strict proportionality between afterimage size and distance. To allow a less ambiguous assessment of proportionality, Experiment 2 used magnitude-estimation procedures. Distance estimates were completely veridical, but afterimage size varied only linearly, and not proportionally, with apparent distance. It was concluded the Boring (1940) was mistaken in his attempt to reduce size constancy and Emmert’s law to the same principle.     

Reaction time as a function of the intensity and probability of occurrence of vibrotactile signals

Three Ss made judgments of the presence or absence of a burst of 60-cps vibration onthe index fingertip.The probability of S’s reporting the presence of a signal was found to be influenced by signal probability and signal intensity. Mean reaction time for reporting the presence of a signal decreased as a function of signal intensity and signal probability whereas mean reaction time for reporting the absence of a signal increased as a function of signal intensity and signal probability. On trials where no signal was presented mean R T for reporting a signal decreased with increases in the signal probability whereas mean RT for reporting the absence of a signal increased with increases in signal probability. The results were interpreted as support for the hypothesis that S’s decision time was longer the closer on the sensory continuum a particular observation was to his criterion.     

Limiting the role of the family in discontinuation of life sustaining treatment

In matters of discontinuation of life-sustaining treatment, traditional role of the family to speak on behalf of the incompetent patient is questionable. We explore the reasons why physicians perceive patient autonomy to be transferrable to family members. Principle of patient autonomy may not suffice when futile treatment is demanded and may serve to erode the ethical integrity of medical profession. An enhanced role for bioethics committees is proposed when physicians propose to discontinue life-sustaining treatment against the wishes of the patient or their families.     

Saccadic reaction times of dyslexic and age-matched normal subjects

Saccadic reaction times (SRT) were measured in a simple task: subjects had to make saccades from a central fixation point to peripheral targets, which appeared randomly 4 deg to the left or to the right. In the first test the fixation point went off before the target appeared (gap trials); in the second test it remained on the screen (overlap trials). The distribution of SRTs for trained normal adults (N = 4), untrained normal adults (N = 11), untrained normal children (aged 9-11 years, N = 9), untrained normal teenagers (aged 15-17 years, N = 8), dyslexic children (aged 9-11 years, N = 15), and dyslexic teenagers (aged 15-17 years, N = 5) were compared, with special emphasis on the number of express saccades, ie saccades with extremely short reaction times (100-120 ms, under the present conditions). In normal adults with the gap paradigm, the distribution of reaction times typically exhibits two or three modes (express saccades, fast regular saccades, and very few slow regular saccades), whereas in the overlap paradigm only one or two modes (few fast regular saccades and many slow regular saccades) are obtained. On average, normal children produce more express saccades than naive normal adults. Dyslexic children produce more express saccades than the normal age-matched controls. Among the dyslexic children, four different types of abnormalities in their reaction times were encountered. The group of dyslexic teenagers was characterized by a larger number of express saccades at the expense of fast regular saccades in gap trials and by fewer express saccades and fewer fast regular saccades in overlap trials when compared to the age-matched control group. It is concluded that the abnormal patterns of saccadic reaction times reflect defects in the system of visual attention and/or in its control over the oculomotor system, rather than indicating a defect in the oculomotor system itself. In this context, symptoms of dyslexia appear as a combination of attentional deficits and irregular timing of saccadic eye movements.     

Procuring organs from a non-heart-beating cadaver: commentary on a case report

Procurement of organs from non-heart-beating cadaver donors raises concerns. Standards for optimal patient care during withdrawal of life-sustaining therapy are evolving and continue to be debated and studied. Consensus on specific procedures and methods has not been attained, however, and protocols for the procurement of organs from patients following the withdrawal of life-sustaining therapies may compromise the evolving standards and harm the patient and the attendant family. In addition, there is little evidence to suggest that such protocols will significantly increase the number of organs procured. "Non-heart-beating cadaver" protocols that do not give comprehensive attention to optimal patient/family care at the time of withdrawal of life-sustaining therapy ought not to be endorsed.     

Social class as a correlate of gender identity among lesbian women

Traditionally, researchers have portrayed butch and femme identities among lesbian women as gender roles. To complicate matters, rather than ask lesbian women to define butch and femme within the context of their own culture, researchers defined the terms themselves. This study adds to the literature in two ways: (1) lesbian women are asked to define butch and femme on their own terms and (2) social class is considered as a correlate to the formation of butch and femme gender identities. A snowball sample of 235 women participated in the study. Ninety-three percent of the participants are white, 7% are women of color. Social classes, as measured by income and education, are diverse within the sample. Findings indicate that lesbian women define butch and femme differently than have researchers, and that social class is a significant determinant of whether or not a lesbian woman defines herself as butch or femme.Part of this paper was presented at the American Sociological Association 1995 Annual Meeting in Washington, DC. I thank Dr. Leonard Beeghley and two anonymousSex Roles reviewers for their valuable comments on earlier drafts.