The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

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.     

The Effects of Leader and Subordinate Characteristics in the Development of Leader–Member Exchange Quality1

This study investigated the contribution of both subordinate and leader characteristics in the development of leader-member exchange (LMX) quality. Data from 56 subordinate-superior dyads working at a large West-coast media company revealed that subordinates high in work self-efficacy were liked more by their supervisors, perceived to be more similar to their supervisors, experienced more positive LMX quality, and were rated as better performers than subordinates low in self-efficacy. Previous job experience, was related only to one outcome; supervisor's liking of the subordinate. Subordinates initially low in self-efficacy benefited from high LMX, as evidenced by increased end-of-program self-efficacy. Perceptions of similarity between supervisor and subordinate were found to be more important to LMX quality than actual demographic similarity. Leader self-efficacy and optimism predicted subordinates' ratings of LMX quality only for female supervisors. Unexpectedly, leader self-efficacy and optimism were related to the leaders' own ratings of LMX and subordinate performance.     

The role of self-efficacy in performing emotion work

This study used a sample of 154 cabin attendants to examine the role of self-efficacy in the performance of emotion work. On the basis of the literature, we hypothesized that self-efficacy would have a moderating influence on the relationship between emotional job demands (i.e., feeling rules and emotionally charged interactions with passengers) and emotional dissonance, and on the relationship between emotional dissonance and well-being (emotional exhaustion and work engagement). In addition, we predicted that emotional dissonance mediates the relationship between emotional job demands and well-being. The results of a series of hierarchical multiple regression analyses generally supported these hypotheses. Results confirmed that emotionally charged interactions with passengers are related to emotional exhaustion and engagement through their influence on emotional dissonance. Furthermore, self-efficacy buffers the relationship between emotional job demands and emotional dissonance, and the relationship between emotional dissonance and work engagement (but not exhaustion).     

Structural Alignment during Similarity Comparisons

Similarity comparisons are a basic component of cognition, and there are many elegant models of this process. None of these models describe comparisons of structured representations, although mounting evidence suggests that mental representations are well characterized by structured hierarchical systems of relations. We propose that structured representations can be compared via structural alignment, a process derived from models of analogical reasoning. The general prediction of structural alignment is that similarity comparisons lead subjects to attend to the matching relational structure in a pair of items. This prediction is illustrated with a computational simulation that also suggests that the strength of the relational focus is diminished when the relational match is impoverished, or when competing interpretations lead to rich object matches. These claims are tested in four experiments using the one-shot mapping paradigm, which places object similarity and relational similarity in opposition. The results support the hypothesis that similarity involves the alignment of structured representations.     

Self‐regulation principles underlying risk perception and decision making within the context of genomic testing

Advances in theory and research on self‐regulation and decision‐making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk‐related decisions. We examine how self‐regulation theory can be applied to inform our understanding of decision‐making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life‐altering decisions. After presenting key principles of self‐regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self‐regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self‐regulation theory.     

“Girls Are as Good as Boys at Math” Implies That Boys Are Probably Better: A Study of Expressions of Gender Equality

Although “Girls are as good as boys at math” explicitly expresses equality, we predict it could nevertheless suggest that boys have more raw talent. In statements with this subject‐complement structure, the item in the complement position serves as the reference point and is thus considered more typical and prominent. This explains why “Tents are like houses,” for instance, sounds better than “Houses are like tents”—people generally think of houses as more typical. For domains about ability, the reference point should be the item that is typically more skilled. We further propose that the reference point should be naturally more skilled. In two experiments, we presented adults with summaries of actual scientific evidence for gender equality in math (Experiment 1) or verbal ability (Experiment 2), but we manipulated whether the reference point in the statements of equality in the summaries (e.g., “Boys’ verbal ability is as good as girls’”) was girls or boys. As predicted, adults attributed more natural ability to each gender when it was in the complement rather than subject position. Yet, in Experiment 3, we found that when explicitly asked, participants judged that such sentences were not biased in favor of either gender, indicating that subject‐complement statements must be transmitting this bias in a subtle way. Thus, statements such as “Girls are as good as boys at math” can actually backfire and perpetuate gender stereotypes about natural ability.     

Seeing What We Know, Knowing What We See: Challenging the Limits of Visual Acuity

Ageism has resulted in overstated expectations regarding the inevitable deterioration in human capabilities, such as visual perception, with age (Rowe and Kahn in Science, 237, 143?C149, 1987; Grant in Health and Social Work, 21, 9?C15, 1996). Human visual perception, however, is of a largely constructive nature, evidenced in the complementary interactions between top-down inputs (e.g., expectations) and bottom-up stimuli (Engel et al. in National Review of Neuroscience, 2(10), 704?C716, 2001; Miller and Cohen in, Annual Review of Neuroscience, 24, 167-202, 2001). Based on this constructive nature, we hypothesized that visual perception may be better than is typically expected. In three experiments, we demonstrated the malleability of visual acuity using a conditioning procedure involving manipulations in bottom-up stimuli. Experimental groups read a book excerpt with one letter in decreased font size, while the control groups read the same book excerpt with all letters in the same font size. Experiment 1 (N?=?112) examined whether visual acuity could be enhanced for a specific letter. Experiment 2 (N?=?70) assessed whether visual acuity could be enhanced for a non-conditioned letter, while Experiment 3 (N?=?108) evaluated whether the visual conditioning effects would transfer to all non-conditioned letters. Visual acuity for experimental groups was significantly better than that in the control groups, speaking to the general malleability of our visual sense.     

Bilingualism: consequences for mind and brain

Building on earlier evidence showing a beneficial effect of bilingualism on children's cognitive development, we review recent studies using both behavioral and neuroimaging methods to examine the effects of bilingualism on cognition in adulthood and explore possible mechanisms for these effects. This research shows that bilingualism has a somewhat muted effect in adulthood but a larger role in older age, protecting against cognitive decline, a concept known as 'cognitive reserve'. We discuss recent evidence that bilingualism is associated with a delay in the onset of symptoms of dementia. Cognitive reserve is a crucial research area in the context of an aging population; the possibility that bilingualism contributes to cognitive reserve is therefore of growing importance as populations become increasingly diverse.