The McMaster Approach to Families: theory, assessment, treatment and research

The McMaster Approach to Families is a comprehensive model of family assessment and treatment. This paper provides an overview of the McMaster Approach and consists of five major sections. First, the under-lying theoretical model (McMaster Model of Family Functioning) is described. Second, the three assessment instruments of the approach (Family Assessment Device, McMaster Clinical Rating Scale, McMaster Structured Interview of Family Functioning) and their psychometric properties are summarized. Third, the family treatment model (Problem Centered Systems Therapy of the Family) is presented. Fourth, the research conducted using the McMaster Approach is reviewed. Finally, the clinical uses and advantages of the McMaster Approach are discussed.     

Helping Clients Manage Addictions with REBT

Most private practitioners of REBT and other cognitive-behavioral therapies avoid work with problems of addiction. Reasons to reconsider this choice are offered and specific methods for productive private work with addictive problems are provided.     

Self-Disclosure and the Therapeutic Frame: Concerns for Novice Practitioners

Under the influence of the intersubjective or relational perspective, guidelines for establishing the therapeutic frame in psychoanalysis and psychoanalytic psychotherapy are undergoing modification. Therapeutic interventions such as disclosing subjective reactions have a sound theoretical basis, but they must be executed judiciously within a context of general neutrality, anonymity, and abstinence. Novice practitioners ought not attempt the more difficult relational interventions until they have acquired experience and security in the basic tenets of psychoanalytic practice, including how to maintain the traditional therapeutic frame. Inexperience in knowing when and under what circumstances to attempt self-disclosure of therapist affect, and insecurity in examining one's countertransference, have the potential to exacerbate enactments and entanglements for beginning therapists, as is illustrated in a case example.     

Depressed patients with dysfunctional families: description and course of illness.

Sixty-eight depressed patients were subdivided according to their family's level of family functioning into functional and dysfunctional groups. Patients from dysfunctional families did not differ from those from functional families on measures of severity of depression, chronicity of depression, depression subtypes, other nonaffective psychiatric diagnoses, history of depression, or neuroendocrine functioning. Patients from dysfunctional families did have significantly higher levels of neuroticism. A 12-month follow-up of these patients indicated that depressed patients with dysfunctional families had a significantly poorer course of illness, as manifested by higher levels of depression, lower levels of overall adjustment, and a lower proportion of recovered patients. Thus, impaired family functioning appears to be an important prognostic factor in major depression.     

Manipulation of visual mental images in children and adults.

Recently, there has been a debate on whether visual patterns can be transformed and reinterpreted in mental imagery. In the present study, task demands and age of subjects were manipulated to see whether children and adults were able to discover a novel visual pattern after transforming a mental image. Two tasks, called combination and subtraction, were devised. They consist of either compounding or taking away parts of images to discover a new construal. Results indicate that not only adults, but also children aged 6 and 10, are able to transform a mental image so as to yield another image with a different interpretation. Task demands had a greater effect on children than adults, consistent with the suggestion that the ease of manipulating mental images is a function of the efficiency of control processes.     

Verbal recoding of visual stimuli impairs mentalimagetransformations

Two experiments were carried out to test the hypothesis that verbal recoding of visual stimuli in short-term memory influences long-term memory encoding and impairs subsequent mental image operations. Easy and difficult-to-name stimuli were used. When rotated 90 degrees counterclockwise, each stimulus revealed a new pattern consisting of two capital letters joined together. In both experiments, subjects first learned a short series of stimuli and were then asked to rotate mental images of the stimuli in order to detect the hidden letters. In Experiment 1, articulatory suppression was used to prevent subjects from subvocal rehearsal when learning the stimuli, whereas in Experiment 2, verbal labels were presented with each stimulus during learning to encourage a reliance on the verbal code. As predicted, performance in the imagery task was significantly improved by suppression when the stimuli were easy to name (Experiment 1) but was severely disrupted by labeling when the stimuli were difficult to name (Experiment 2). We concluded that verbal recoding of stimuli in short-term memory during learning disrupts the ability to generate veridical mental images from long-term memory.