The role of theory in treating adolescent substance abuse

The adolescent substance abuser, like adult addicts, is most commonly considered from the perspective of the disease model. The usefulness of the disease model in conceptualizing adolescent substance abuse is questioned, and an alternative view of the topic is set forth. Substance abuse, is regarded as an adaptive aspect of the ongoing interactive processes within the family. The developmental process of the adolescent substance abuser is seen as a functional dynamic in the family's preservation. Three characteristic elements of parental interaction common to the development of adolescent substance abuse are highlighted.An earlier version of this paper was presented at the Texas Association for Marriage and Family Therapy annual conference on January 28, 1993 in Houston Texas.a research associate and director of the Don D. Jackson Archive at the Mental Research Institute, Palo Alto, CA. Authors are listed alphabetically.     

Marcel's “availability” in existential psychotherapy with couples and families

Gabriel Marcel was a French, Catholic, existential philosopher who first presented the concept of human availability as a central way of strengthening the self and facilitating the experience of human freedom. In this article Marcel's ideas about availability are described, reviewed, and examined for their implications for the practice of existential psychotherapy with couples and families.     

Long term marriages in Sweden: And some comparisons with similar couples in the United States

This international, five-country long term marriages study of couples who have been married, or unmarried and cohabiting, for 20 years or longer is designed to study, among other things, marital satisfaction. This first report of the Swedish part of the study reports on a Swedish version of the self-rating Dyadic Adjustment Scale (DAS) used to investigate self-rated marital satisfaction. The couples describe high marital satisfaction and a high sense of coherence (SOC) compared to other groups. Contrary to other studies, no differences were found between men and women regarding SOC. The differences between them, that describe high relative to low marital satisfaction, pertain to matters of recreation, sex, life philosophy, time spent together, and frequency of quarrels. The men reported greater marital satisfaction than the women.     

Stress and family support as predictors of distress and rejection in people who care for a relative with schizophrenia

Relatives (N=121) of adult schizophrenia patients were interviewed to investigate predictors of their level of psychological distress and of rejecting attitudes toward the sufferer. The relatives' total stress, particularly that associated with poor communication skills in the sufferer, predicted several measures of their psychological distress, and the same variables plus turbulence of sufferer behavior (i.e., violence and disruptiveness) predicted rejection of the sufferer by the relative. In each case, adequacy of family support moderated the influence of the stressors, although this effect was more marked for distress outcomes than for rejection. The results have important implications for the sorts of professional and peer support which relatives may need to encourage their performance of this potentially burdensome role. In addition, the results fit a classic stress management model and provide a feasible alternative to the Expressed Emotion Model of the relationship between relatives' rejection and patients' illness severity.     

Social-Cognitive and Behavioral Correlates of Aggression and Victimization in Boys' Play Groups

A contrived play group procedure was utilized to examine the behavioral and social-cognitive correlates of reactive aggression, proactive aggression, and victimization via peers. Eleven play groups, each of which consisted of six familiar African-American 8-year-old boys, met for 45-min sessions on five consecutive days. Social-cognitive interviews were conducted following the second and fourth sessions. Play group interactions were videotaped and examined by trained observers. High rates of proactive aggression were associated with positive outcome expectancies for aggression/assertion, frequent displays of assertive social behavior, and low rates of submissive behavior. Reactive aggression was associated with hostile attributional tendencies and frequent victimization by peers. Victimization was associated with submissive behavior, hostile attributional bias, reactive aggression, and negative outcome expectations for aggression/assertion. These results demonstrate that there is a theoretically coherent and empirically distinct set of correlates associated with each of the examined aggression subtypes, and with victimization by peers.     

An Evaluation of the Health Belief Model for Predicting Perceived and Actual Dietary Quality1

The health belief model was evaluated for its ability to predict perceived and actual dietary quality. The assessment relied upon data collected from 1,502 respondents by the US. Department of Agriculture in its 1991 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey. The health belief model provided good prediction of perceived dietary quality, but provided moderate to weak prediction of 7 measures of actual dietary quality that were calculated from food intake records. Implications are suggested for using the health belief model to understand the determinants of dietary quality.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

MFT trainee adjustment to program lifestyle stress: The TAPS scale

The 30-item Trainee Adjustment to Program Stress (TAPS) scale was developed to measure lifestyle stress of family therapy trainees. Initially, 70 items were generated from propositional statements based on four constructs. Following pilot testing, 329 out of 900 (37%) student members of the American Association for Mariage and Family Therapy (AAMFT) returned TAPS questionnaires. Internal consistency reliability analyses and principal components and factor analyses produced a final 30 item TAPS scale appropriate for use in family therapy training programs. Reliability and validity measures are reported.     

Boundary regulation in family and personal systems: Perceptions of late adolescents

Examination of boundary regulation can provide family therapists with a framework to describe both the functioning of family systems and personal systems (i.e., the intrapsychic functioning of individual family members). In the present study, late adolescents' perceptions of boundary regulation within their family systems (i.e., ratings of family health, communication, leadership, expressiveness, cohesion, and family conflict) were related to regulation of their personal boundaries (i.e., self-reported personal competence, distress, and patterns of defense mechanism use). In addition, personal system variables reliably discriminated between adolescents who described their families as psychologically healthy versus psychologically unhealthy.