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181.
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
182.
Perceived parental acceptance and female juvenile delinquency 总被引:1,自引:0,他引:1
S E Kroupa 《Adolescence》1988,23(89):171-185
The responses of 62 adolescent females residing at a state training school and 62 high school females on a measure of perceived parental acceptance were compared while statistically controlling for mental age, chronological age, socioeconomic status, social desirability, and family structure. Generally significant (p less than .05) results indicate that incarcerated females viewed their mothers and fathers more negatively than did nonincarcerated females. Slightly more ambivalent results were indicated in the mother-daughter relationship (delinquent girls reported mothers to be more rejecting/neglecting than did nondelinquents, but no significant differences were found between the groups on perceived mother acceptance) than in the father-daughter relationship. Results were discussed in terms of reported parental differences in acceptance-nonacceptance, providing limited support for Ausubel's satellization theory of child development, and the difficulty of inferring causality from retrospective self-report studies using "captive" subjects. 相似文献
183.
As part of a large survey of addictive behavior in high school students, 43% of a sample of 278 (26% of the males, 57% of the females) scored above the cutoff point set by Overeaters Anonymous on their scale for assessing compulsive overeating. While this at-risk group did not report poorer general adjustment, health, or school achievement than did the students not at risk, they did significantly more often perceive their life quality and relationship with the person closest to them as less positive. The at-risk subsample indicated the defensive effectiveness of overeating in their significantly more frequent report of dissociative experiences while eating, and less severe ratings of insecurity, worrying, and daydreaming. One of the most salient findings was the at-risk students' more frequent report of addictive problems in their parents (overeating, alcohol and drug use, and gambling). 相似文献
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186.
Four clinical examples of oedipal-based transference across gender lines are presented with the aim of illustrating (1) its existence, (2) the defenses against its emergence, and (3) the use of the analyst's gender as both an organizer of and resistance to certain transference manifestations. Factors that contribute to the availability for analysis of cross-gender transference are discussed, as are the resistances and other obstacles to its actualization. 相似文献
187.
Randy O. Frost Joan E. Morgenthau Catherine K. Riessman Margaret Whalen 《Behaviour research and therapy》1988,26(6):481-487
The study examined physical symptoms and health service utilization of subjects high or low on a measure of the tendency to experience stress somatically and high or low on a measure of current stress. High somatic responders reported greater numbers of symptoms than low somatic responders regardless of stress level. However, high somatic responders who were experiencing high levels of current stress reported significantly more symptoms than high somatic responders who were experiencing low levels of stress. These findings indicate that somatic response to stress reflects both a general tendency to focus on physical symptoms, and a specific tendency to focus more on physical symptoms when under stress. Analysis of health service records indicated that high somatic responders had more visits prompted by symptoms than low somatic responders, but did not differ in frequency of health service visits designed to maintain health. The findings further clarify the relationship between somatic response to stress, physical symptoms and health service use. 相似文献
188.
Recidivism data derived from various sources over a follow-up period of 1–11 yr, provided the basis for appraising the effectiveness of a comprehensive cognitive-behavioral treatment program for familial and nonfamilial child molesters. Unofficial records held by police and Children's Aid Societies proved to be the best data for estimating recidivism. These data revealed increases in recidivism with longer follow-up periods, but there were consistent advantages for the treated over the untreated patients. Men who had sexually abused the daughters of other people demonstrated the clearest treatment benefits. The younger offenders and those who had engaged in genital-genital contact with their victims were more likely to reoffend even if they were treated. Contrary to the expectations of behavior therapists, indices of deviant sexual preferences did not predict outcome. 相似文献
189.
Is paranoid schizophrenia really camouflaged depression? 总被引:4,自引:0,他引:4