Families with Physically Handicapped Children: Social Ecology and Family Systems

This paper reviews research on families with physically handicapped children, and integrates this work within a social ecological perspective. Methodological difficulties in past research that contribute to a lack of consensus in the area are discussed. Research on stresses experienced by various subsystems within families with handicapped children is presented, with recommendations for future family-oriented research and intervention. The interactions of families with handicapped children with their social support networks are reviewed, underscoring the importance of these processes for coping and adaptation.     

The effect of social influence on cognitive development and school performance

Three months before school entrance a sample of 29 children and their mothers was tested for degree of decentred child educability and degree of decentred maternal teaching. Mother and child were tested in two different situations, thus preventing interdependency between the measures of mother and child. Four months after school entrance, teacher judgements of school performance were obtained. A strong correspondence between degree of decentred child educability and degree of decentred maternal teaching was demonstrated. Degree of decentred maternal teaching and degree of decentred child educability were found to be good predictors of school performance, accounting for respectively 45 and 33% of the variance in school performance. In contrast a test of school readiness only accounted for 2% of the variance. A test of intelligence given after the teacher judgement accounted for 31% of the variance. The fact that the mother seems to be a better predictor of her child's school performance than the child himself, supports the assumption that parents, particularly mothers, are important mediators between the child and the outer world.     

The Relationship of Purpose in Life to Coping Strategies and Time Since the Death of a Significant Other

The authors investigated the relationship of experienced purpose in life to strategies used to cope with a loss resulting from death and the amount of time since the loss. Forty undergraduates who had suffered the death of a significant other completed an information sheet, the Purpose in Life Test, and the revised Ways of Coping Checklist. People who experienced low purpose in life reported using more emotion-focused coping strategies than did individuals with high purpose. These results are linked to the literature on emotion-focused coping and depression and are discussed in terms of the assessment and preventive treatment of bereaved clients.     

The Moral Significance of Birth

Does birth make a difference to the moral rights of the fetus /infant? Should it make a difference to its legal rights? Most contemporary philosophers believe that birth cannot make a difference to moral rights. If this is true, then it becomes difficult to justify either a moral or a legal distinction between late abortion and infanticide. I argue that the view that birth is irrelevant to moral rights rests upon two highly questionable assumptions about the theoretical foundations of moral rights. If we reject these assumptions, then we are free to take account of the contrasting biological and social relationships that make even relatively late abortion morally different from infanticide.     

The Growing Feminist Debate over the New Reproductive Technologies

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related issues as racism, sexuality, motherhood and abortion.     

Women,Work, and Life Transitions

Work is a positive force in helping women manage the issues and problems caused by separation and loss. The role of the employment counselor can be crucial during the process of transition.     

The Excitation-Adaptation Model of Pediatric Chronic Illness

This article examines the value of the psychosomatic family model for the study of chronically ill children. Four conceptual problems arise in the discussion of this model: the unidirectional causality of the model; the function of the sick child for the family system; the pathology of the family characteristics; and the disease type. In the present study, we propose (a) that a distinction be made between uncontrolled and controlled forms of disease, and (b) that the family characteristics of "cohesion" and "adaptation" be examined in relation to the parental capacity for problem solving and the acceptance or rejection of the child by the parents. This is shown by means of empirical research. In this empirical study, 20 families with a child suffering from controlled asthma are compared with 20 families with a child suffering from uncontrolled asthma. Contrary to the assumptions derived from the psychosomatic family model, the results show significantly more cohesion and structure in the group with a child suffering from controlled asthma. The findings from this study are integrated in a new model for the study of chronic childhood illness —"the excitation-adaptation model." In this model, two circular processes are emphasized involving (a) the progress of the illness and the way in which parents and child deal with medication and medical advice (therapy compliance), and (b) the factors influencing the therapy compliance on the part of the parents, the family, and the child. By studying these factors in connection with the management of the illness, it should become clear whether family characteristics are adaptive or pathological.     

Relational Control Patterns and Expressed Emotion in Families of Persons with Schizophrenia and Bipolar Disorder

The process of relational control, that is, the negotiation of “who's in charge,” was examined in 40 families of persons with schizophrenia and bipolar disorder. Verbal interaction recorded during problem-solving tasks was coded with the Relational Control Coding System (RCCS). Patterning of message and response sequences was compared by diagnosis of the patient and level of expressed emotion (EE) of the family. Results indicated that patients with either diagnosis assert control more than their parents, that high-EE families compete for control more than low-EE families, and that families of bipolar patients compete for control whatever their EE status. The most dramatic differences in control patterns were in the dual-parent, high-EE families of persons with schizophrenia, in which the patients successfully challenged parents for control, and parents often yielded. It was concluded that EE reflects transactional processes in families that vary by diagnosis of the patient.     

Competency-Based Employment-Counseling Model: Local Office Implementation

This article describes the early stages in the implementation of the competency-based employment-counseling model in a local employment office in Kentucky. Preliminary steps taken at both the state and local levels are discussed. The actual application of the model in the Louisville local office is then presented. The conclusions provide several key factors to successful initial implementation.