On second-order family therapy

If family therapists remain aware of the indivisible and recursive nature of their interactions with families, and if they use this awareness to form a collaborative rather than a hierarchical therapeutic system, and at the same time minimize their attempts to change persons or family structures in strategic or predetermined ways, then they may be said to be practicing a "second-order" family therapy. This article analyzes the development of the second-order position on therapist power and influence, concluding that it is inconsistent and possibly disingenuous.     

The capacity to forgive: An object relations perspective

Forgiveness is commended by Christianity, as well as other religious traditions, as one of the most central of virtues, so central that the New Testament links man's very salvation to his ability to forgive. However, mental health professionals have correctly pointed out that the mandate to forgive is often used by religious patients in the service of defenses such as reaction formation, undoing, and denial. The forgiveness ideal is often misunderstood as a command not to experience aggressive feelings.It is the thesis of this paper that the capacity for genuine forgiveness is central not only to spiritual development but to psychological development as well. It is suggested that Kernberg's object relations theory provides the best model for understanding the nature and importance of forgiveness. Mature forgiveness does not involve the elimination of negative feelings toward others (or oneself) but the integration of negative and positive self-object representations and their connected affect. Anger at the offending persons must then be tempered by appreciation for their concomitant good qualities and motivations or, at the very least, empathy for the flaws which prompted them to behave destructively. The result is a more realistic and balanced view of others (and oneself), a more genuine relationship to the full range of one's own inner experience, and a greater ability to respond constructively to frustrating persons and situations.This paper was presented at the Annual Meeting of the American Psychological Association in New York in August 1987. The author wishes to thank Mark Finn, Ph.D., and David Hamblin, Ph.D., for their valuable discussions in the development of the ideas in the paper. Address requests for reprints to Dr. Gartner, Dept. of Pastoral Counseling, Loyola College, 7135 Mistrel Way, Columbia, MD 21045.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

A comparison of alternative theoretical approaches to smoking cessation and relapse

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.