The impact of the therapeutic environment

This paper emphasizes the impact of the setting, space, and general physical properties of the clinic upon the difficult patient's profound neediness and absence of inner regulatory structure. Moreover, the clinic's administrative style and requirements often related to fiscal restraints, demands for accountability for both how funds are spent and treatment outcome, all impinge upon the patient. Humanizing clinics so they have the capacity for psychotherapeutic holding and provision of safety for difficult patients are discussed in detail in this contribution.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

An Investigation of the Professional Travel Environment

In this study the authors compared women's and men's reactions to various professional travel situations. A multivariate analysis of covariance was used to determine the effects of sex, professional role, and years traveling on the perceptions of these travel situations.     

Career Counseling Implications with the Gay and Lesbian Population

In this article, the author identifies resources available to assist the gay and lesbian population with career planning and job search concerns. Evolving legal issues are also discussed.     

Sources of Test Information

In this article the author lists and discusses sources of test information, with special attention on information given to what will be valuable to employment and career counselors.     

Symbiosis, the Family, and Natural Systems

Family systems theory, as developed by Murray Bowen, has its conceptual basis in natural systems. A basic premise is that emotional process is not unique to homo sapiens and that human behavior might better be understood by observing this process in the broader context of all natural systems. This essay discusses the phenomenon of symbiosis as it is used in the natural sciences and as it relates to the emergence of increasingly complex systems in nature. Finally, the emergence of the parent/offspring symbiosis from its possible origins to its development in the human family is discussed.     

A record-keeping format for training systemic therapists

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.     

Systemic crisis intervention as a response to adolescent crises: an outcome study

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent-precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.