An Effect Of Change In Patient Status On Marital Interaction

In the treatment of couples and families, even more so than of individuals, therapists invariably are forced to face the problem of assessment of change in the marital or family "system." The purpose of the present study was to investigate changes in marital interaction for a special population, that is, in which one member of each married pair had been, but was no longer, a hospitalized psychiatric patient. The primary question we addressed was whether changes in marital interaction could be amply detected and whether these changes could be attributed to the particular role shift that had occurred in one spouse--from "patient" to "nonpatient." Utilizing a technique called Interaction Testing, which the senior authors devised in 1960, we found that such alterations in marital interaction do indeed arise when one member of the couple moves out of a patient role and that our instrument is useful in elucidating the nature of such effects. In addition, it can be expected that a study of this kind will be of theoretical and methodological value in dealing with the general issues of problem-solving interaction in couples and families. The clinical aspect of the study may also be expected to stimulate useful thinking regarding family theapy in hospital settings, patient management, and aftercare.     

Power Relationships in Families: A Social-Exchange Perspective

Although researchers have investigated power relationships in families for twenty-five years, conclusions about normative family power patterns have been inconsistent and contradictory. Comparisons across studies have been difficult owing to different definitions of the construct, multiple methodologies, and inconsistent goals. With such confusion, a new, more integrated theoretical approach to the power issue seems warranted, as is suggested by the present paper. The current individual focus on power as a personal attribute can be replaced by a more dynamic, reciprocal, interactive process. Instead of specific or stable power patterns, power interactions should be fluid and time- or situation- specific. No one member would dominate, since power involves a mutual relationship system that changes its content, though not its rules of operation, across decision-making areas. Furthermore, family adjustment would relate to those rules and the family members' reactions to their particular exchange system but not to specific types of power structures. With these considerations, future research should analyze the process, not the content, of power operations in order to maximize the clinical and theoretical utility of its construct.     

The effectiveness of an ombudsman

Most people in our colleges and universities believe that the concept of an ombudsman, developed in the political area, could have a significant influence in institutions of higher education. In this article the author, himself a full-time ombudsman at a large urban college, attempts to correct some prevailing misconceptions about the office and indicate the source of an ombudsman's effectiveness.     

Employment Counseling for Adults With Attention-Deficit/Hyperactivity Disorder: Issues Without Answers

This article provides an overview of issues employment counselors will face in counseling adults with attention-deficit/hyperactivity disorder (ADHD). There is little research on counseling clients with ADHD, and counselors are often ill prepared to provide appropriate services for this growing and underserviced population. Reviewed is the evolution of the ADHD label and its prevalence in adults. Diagnostic criteria are presented, and a selected review of adult outcome and treatment research is provided. Strategies for counseling adults with ADHD about careers are adapted, with caution, from literature on counseling adults with learning disabilities (LD), and specific guidelines for the employment counselor are presented.     

Community and Christianity in the Black Church

The authors explore the experience of Christian religion for many African Americans. In response to racial discrimination and prejudice within churches, African Americans developed a Christian tradition with distinct meanings, beliefs and practices. This tradition provides a foundation for social activism within the church, community and American society, as well as community among church members. The recent Black church burnings are discussed with respect to the more traditional Christian African American view of religion. Implications for incorporating the religious traditions of Christian African Americans into counseling practice are explored. (The authors use the term Black church or African American church as a surrogate for Christian African American church throughout the article. The terms Black and African American will also be used interchangeably).     

Training and Supervising Counselors: Lessons Learned From Deliberate Psychological Education

A psychological education curriculum package designed to stimulate growth in three target areas (psychologival development, mastery of skills, and understanding concepts) was piloted with 18 in-service counselors and teachers. Although significant gains were achieved in counseling skills and moral reasoning, shifts in ego and conceptual level failed to reach statistical significance. Bernier considers these results in light of developmental and cognitive theory and discusses implications for training and supervision. He presents a case for viewing counselor education within a developmental perspective.     

Religion and Substance Abuse Treatment: Individual and Program Effects

The relationship between personal religiousness and substance abuse treatment outcomes has emerged as an important issue in the public health arena. Using the “moral community” perspective, a conceptual framework developed by Stark, Kent, and Doyle (1982) to analyze the contextual effects of religion, we explore the degree to which religion influences two drug treatment outcome measures—critical retention and commitment to treatment. The data are derived from the Drug Abuse Treatment Outcome Studies (DATOS), a national study of 10,010 clients enrolled in 70 drug treatment programs. Three research questions were addressed: (1) What is the relationship between an individual's level of religiosity and retention in treatment and commitment to treatment? (2) How does the ecological context of treatment programs shape the individual‐level relationships? (3) To what extent are program practices and characteristics directly linked to outcome level? The findings are supportive of the literature that shows a weak to moderate relationship between religiosity and treatment outcomes. However, the findings did not show strong support for the “moral community” hypothesis. Although there was a wide variation in the size of the individual‐level religiosity–treatment correlations, the variation could not be conclusively attributed to the overall religious emphasis of the programs. The findings suggest that further research is needed in order to understand fully the role of religion in substance abuse treatment.