Factors influencing failure to show for a family evaluation

Abstract

An important issue in clinical practice concerns clients' failure to keep their initial evaluation appointments, which has been termed defection (Shapiro and Budman, 1973). Research findings and clinical impressions suggest that client defection can be related to three sets of factors: actuarial variables, client psychological and motivational variables, and client-clinician interaction prior to the initial appointment (Rubinstein and Lorr, 1956; Garfield, 1971). Among the actuarial variables, the following have been suggested as being related to clients' defection: referral source, distance client must travel for the appointment, client socioeconomic status (SES), and waiting time (Brill and Storow, 1960; Raynes and Warren, 1971; Lorion, 1973).     

Nicknames of notorious American twentieth‐century deviants: The decline of the folk hero syndrome

This report examines the public use of personal nicknames for notorious American Twentieth Century Deviants. The analysis documents the frequency of nicknames by decade in the twentieth century, the category of the deviant act committed by the person nicknamed, and the connotations of the nicknames. The relationship between the use of nicknames for deviants, and deviants as folk heroes is explored. The data indicate that the public use of personal nicknames for deviants peaks in the 1920's and 1930's and has been declining ever since. This phenomenon parallels the decline in American's belief in the “rags to riches” type of folk hero.     

The effect of continuous, intermittent, and "placebo" reinforcement on the effectiveness of the conditioning treatment for enuresis nocturna

It has been suggested that intermittent reinforcement may be of value in reducing the rate of relapse in bedwetting conditioning therapy. An experiment was conducted with 30 enuretic boys to examine acquisition and extinction parameters of continuous (100%), intermittent (70% variable ratio), and “placebo” (0%) reinforcement schedules. Reinforced trials were administered as in the typical Mowrer conditioning procedure. Non-reinforced trials were achieved by means of a time delay with the subsequent alarm being activated in the parent's room rather than in the child's room. These procedures required the development of a new conditioning device which could be programmed to automatically administer the desired schedule of reinforcement. The results of the field investigation revealed that continuous reinforcement (CR) and intermittent reinforcement (IR) groups attained acquisition in approximately the same number of trials and with essentially the same success rate. Relapse rate was significantly greater in the CR group than in the IR group. The placebo group showed no improvement over the 6 weeks of treatment. The results of this study may be interpreted as supporting the tenet that relapse can be viewed and treated as an extinction of the acquired response.     

Measurement of Preoperative Anxiety in Young Children: Self-report Versus Observer-rated

The utility of the self-report Children’s Anxiety and Pain Scale Anxiety subscale (CAPS-A) in comparison to the widely used, observer-rated Modified Yale Preoperative Anxiety Scale (mYPAS) in assessing anxiety in children undergoing day surgery procedures was examined. The CAPS-A test-retest reliability, concurrent validity with the Modified Yale Preoperative Anxiety Scale (mYPAS), and sensitivity to expected increases in anxiety at stressful times during the preoperative period were examined. Levels of observer-rated (mYPAS) and self-reported anxiety (CAPS-A) were obtained from 61 children (3 to 6 years) undergoing day surgery procedures. The CAPS-A demonstrated adequate test-retest reliability. Concurrent validity between the CAPS-A and mYPAS scores was poor. The CAPS-A failed to show sensitivity to the expected increases in anxiety at stressful time-points. Thus, an alternative scoring strategy for the CAPS-A was proposed (i.e., child’s refusal to point was scored as high anxiety). Post-hoc analyses demonstrated good concurrent and adequate convergent validity with the alternative scoring strategy.