Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Adolescent compliance with dietary guidelines: health and education implications

Through school-sponsored health fairs, 398 adolescents (153 males and 245 females) between the ages of 14 and 18 completed a questionnaire on their compliance with six of the U.S. Dietary Guidelines. Results indicated that adolescents report highest compliance on "eat a variety of foods" and "eat foods with adequate starch and fiber." Conversely, they indicated low compliance on "reduce sugar intake" and "reduce fat, saturated fat and cholesterol intake." Sex differences were noted on two dietary guidelines. Females reported lower compliance with respect to "maintain desirable body weight." Males, on the other hand, reported lower compliance than females on "reduce salt intake." Given the fact that the dietary guidelines of "reduce fat, saturated fat and cholesterol," "maintain desirable body weight," and "reduce salt intake" are all aimed at reducing cardiovascular risk, the low compliance reported by adolescents may have long-range health implications.     

Perceived family environment as a moderator of young adolescents' life stress adjustment

A longitudinal design was employed to test the main and stress-moderating effects of young adolescents' perceived family environment (Family Environment Scales; FES; Moos & Moos, 1981) on their depression, anxiety, and self-esteem. This study was part of a larger longitudinal project (L. Cohen, Burt, & Bjorck, 1987) that demonstrated the significant cross-sectional effects of the young adolescents' controllable and uncontrollable negative events, and the significant longitudinal effects of the former. The present cross-sectional analyses demonstrated the hypothesized main effects of the FES scores; families perceived as cohesive, organized, and expressive were related to positive psychological functioning, whereas families perceived as conflict-ridden and controlling were related to negative functioning. However, in general these effects were nonsignificant in the longitudinal analyses. Although there were a number of significant Negative Events x FES interactions, in no instance did the pattern support the hypothesized stress-buffering role of positive family climate.