The impact of the therapeutic environment

This paper emphasizes the impact of the setting, space, and general physical properties of the clinic upon the difficult patient's profound neediness and absence of inner regulatory structure. Moreover, the clinic's administrative style and requirements often related to fiscal restraints, demands for accountability for both how funds are spent and treatment outcome, all impinge upon the patient. Humanizing clinics so they have the capacity for psychotherapeutic holding and provision of safety for difficult patients are discussed in detail in this contribution.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

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.     

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.     

CHILD-REARING BELIEFS WITHIN DIVERSE SOCIAL STRUCTURES: MOTHERS AND DAY-CARE PROVIDERS IN MEXICO*

The child-rearing beliefs of 32 mothers and 36 day-care providers in Mexico were compared. Day-care providers expected children to master developmental skills at an earlier age than did mothers. Day-care providers more strongly valued the development of independent and cooperative behavior, and placed less importance on obedience. They also reported employing more flexible and nonauthoritarian discipline strategies than did mothers. Mothers and caregivers did not differ in the extent to which they attributed the success of their discipline strategies to their own actions rather than to external factors. Also examined was how mothers' beliefs differed in families characterized by interdependent versus individualistic social structures. In interdependent families, mothers were more likely to believe in later mastery of developmental skills and to make external attributions. These findings suggest that Mexican children experience incongruous social norms as they move between home and day care settings, and that these norms, at least within the home, are associated with the social structural features of the setting.     

Heat and Violence: New Findings from Dallas Field Data, 1980–19811

Research in both laboratory and field settings has suggested a link between thermal stress and violent behavior, and both linear and curvilinear models have been investigated. A dearth of field studies prompted the analysis reported here, which is based on data for some 10,000 aggravated assaults occurring the City of Dallas in 1980 (a summer of severe heat stress) and 1981. This analysis replicates and extends certain aspects of recent work by Anderson and Anderson (1984) relating to the so-called linear and curvilinear hypotheses. Thermal stress is measured in two ways: a Discomfort Index (DI), which takes into account the influence of humidity acting in concert with temperature, and ambient temperature. Regression analyses were performed in two stages. In the first, data for all neighborhoods and all days of the study period were combined into ambient temperature and DI models. At the second stage, models differentiated between the three levels of neighborhood socioeconomic status. With weekend controlled, DI and ambient temperature were significant independent variables in the ‘overall’ model and in medium and low status neighborhoods. However, when linear effects were controlled, the curvilinear measures were never significant. The analysis generally tended to confirm Anderson and Anderson's suggestion that a reduction of aggression with increasing temperature does not appear to occur within the normal range of temperatures. This analysis further suggested that the hypothesized curvilinear effect is weak, if not entirely absent, even during conditions of extreme heat.