Children's understanding of death according to parents and pediatricians

Thirty pediatricians and 30 parents were interviewed on (a) how and when children develop concepts about death, (b) children's emotional responses to the thought of death, (c) the possibility of dialogue between adults and children about death, and (d) differences in healthy and seriously ill children's conceptualization of death. Pediatricians were no different than parents in their opinions. Moreover, in some cases, less educated parents and older doctors tended to hold opinions that were even farther from reality. Overall, the results suggest that children, healthy or sick, are left alone with the problem of death and are not helped either by their parents or by their doctors.     

A record-keeping format for training systemic therapists

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.     

The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

Systemic crisis intervention as a response to adolescent crises: an outcome study

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent-precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.     

Systemic Optimism — Systemic Pessimism: Two Perspectives on Change

Therapists have a mandate to bring about change, and family therapists appear to have unusual leverage to fullfill such a mandate, that is, to facilitate changes rapidly and effectively. Because and in spite of this mandate, the very notion of change deserves critical reflection. The history of ideas and our clinical experience teach us that changes may be problematic. They may come too fast or too slowly, may endure or fade away, may turn out to be desirable or undesirable, equitable or inequitable, and may, when further consequences and larger systems levels are taken into account, be beneficial or disastrous. This essay examines some of the problematical and contradictory aspects of change and delineates two perspectives on change--systemic optimism and systemic pessimism.     

A COMPARISON OF PEER-DIRECTED AND TEACHER-DIRECTED EMPLOYMENT INTERVIEW TRAINING FOR MENTALLY RETARDED ADULTS

Interview skills deficits may limit employment prospects of mentally retarded adults. Although numerous papers highlight the importance of interview skills, few have validated effective strategies for use with mentally retarded persons. Further, there has been a lack of research contrasting rival interview skills training strategies. The present study was conducted with two mentally retarded young adults. It contrasted peer-directed instruction, in which both participants were equally deficient in the target skills, with teacher-directed instruction. Results of the investigation indicated that instruction, rehearsal, and feedback may be effective strategies regardless of who provides instruction. Comparisons of teacher-directed and peer-directed instruction indicated little or no difference in the effectiveness of the two procedures. However, the peer-directed procedure involved considerably less staff time than did the teacher-directed procedure.