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The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*
Ellen Pulleyblank Coffey Ph.d. Mary E. Olson Ph.d. Phebe Sessions Ph.d. 《Family process》2001,40(4):385-399
This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care. 相似文献
34.
John W. Schuster David L. Gast Mark Wolery Sharon Guiltinan 《Journal of applied behavior analysis》1988,21(2):169-178
The effectiveness of a 5-s constant time-delay procedure to teach three chained food preparation behaviors to four moderately retarded adolescent students was evaluated within a multiple probe design across behaviors. Results indicate that the procedure was effective in teaching all four students to make a sandwich, boil a boil-in-bag item, and bake canned biscuits. The skills maintained with at least 85% accuracy over a 3-month period. Training generalized from the school to the home setting for the 2 subjects that completed generalization probe sessions. The percentage of errors across all skills and students was less than 9%. 相似文献
35.
David Wilson Alastair Mundy-Castle Ruth Greenspan 《International journal of psychology》1988,23(1-6):637-646
Six-hundred and thirteen girls and 601 boys in Zimbabwe completed the Junior Eysenck Personality Questionnaire (JEPQ). The reliability of the Neuroticism (N) and Social Desirability (L) factors was acceptable but the Psychoticism (P) and Extraversion (E) factors possessed modest reliability. While the factorial validity of the P, N and L scales was acceptable, the factorial validity of the E scale was poor. L scores were significantly correlated with N and P scores among girls and boys. Whereas Zimbabwean girls reported higher P scores than did Canadian girls, Zimbabwean boys reported lower P scores than did Canadian boys. Zimbabwean girls and boys reported lower E and N and higher P scores than their Canadian counterparts. This study provides broad support for Eysenck's basic personality model, but it does not support the use of this version of the JEPQ, and especially the E scale, among Zimbabwean children. 相似文献
36.
The influences of sex, age, and conversational, partner (mother vs. stranger) on eye contact during verbalizations were examined in a longitudinal study of 33 children at 2 and 4 years of age. A free-play sample was obtained of each child interacting with mother and with a male or female experimenter. The amount of eye contact in conjunction with verbalization was analyzed. Significant main effects were found for sex (females engaged in a higher percent of eye contact than males) and conversational partner (more eye contact while speaking exhibited to experimenter than to mother). There was an interaction between age and conversational partner, in that mother received more and experimenter relatively less percent of eye contact during verbalizations as children got older. Notably, there was no main effect for age. These results revealed sex differences at an age (2–2 1/2 years) and in a context (free-play setting) not previously studied, demonstrating the robustness of the effect. Further, age findings seem indicative of unique developmental trends for eye contact during verbalizations for the ages between 2 and 4 years.Mount Saint Vicent University 相似文献
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Previous theories of intrinsic motivation have traditionally ignored the experiential or subjective aspects of engagement in intrinsically and extrinsically motivated tasks. Part of the reason for the lack of research in this area was our ignorance of which emotions to study. Data are presented here from two studies designed to produce the first systematic evidence of changes in basic emotional states during task engagement. Our findings suggest that intrinsic and extrinsic tasks can be differentiated according to the emotional changes subjects retrospectively report about their engagement with these tasks, and point the way to future research incorporating emotion as an important variable to consider.The first author was supported in part by a Minority Fellowship administered by the American Psychological Association under a Clinical Training Grant from the National Institute of Mental Health (5 T01 MH13833), and by a Regents Fellowship from the University of California, Berkeley. 相似文献
39.
David Widerker 《Erkenntnis》1988,28(2):269-291
I would like to thank Eddy Zemach, Jonathan Stavi, Julius Moravcsik and Dov Gabbay for some very good discussions on the logical form of action sentences. Also, I am indebted to an anonymous referee of Erkenntnis for some very helpful comments on an earlier draft of this paper. 相似文献
40.
Jeffrey S. Levin Ph.D. M.P.H. C. David Jenkins Ph.D. Robert M. Rose M. D. 《Journal of religion and health》1988,27(4):267-278
In a study of air traffic controllers, religious differences are found in the way Type A behavior is associated with several health status indicators. Associations between the Jenkins Activity Survey (JAS) and physical illness incidence, health-promotive behavior, diastolic and systolic blood pressure, subjective distress and impulse control problems, and alcohol consumption are examined by religious attendance, religious affiliation, and change in affiliation. Findings confirm that Type A does not vary significantly by religion. However, there are several significant findings between Type A and various health indicators. Type A is associated with illness incidence, overall and more strongly in several religion, subgroups. Type A and alcohol consumption are related positively in Protestants and converts, and negatively in churchgoing Catholics. Type A is related to impulse control problems in churchgoing Protestants and to subjective distress in churchgoing Catholics. Finally, in individuals with weak or no religious ties, Type A is associated with lower blood pressure. This last finding suggests that in some people (for example, the irreligious or unchurched), the coronary-prone behavior pattern may have cardiovascular effects which are salutary in at least one respect.The authors wish to thank Dr. Kyriakos S. Markides and Laura A. Ray for their assistance with this study. Address requests for reprints to Dr. Levin at the Institute of Gerontology, 300 North Ingalls, Ann Arbor, MI 48109. 相似文献