Family therapy with problem drinkers and drug takers: A pilot follow-up study

We report a retrospective outcome study of 36 problem drinkers and/or drug takers, treated with structural-strategic family therapy. The interval between treatment and follow-up varied from six months to two years. Follow-up data was available on 34 cases. Twenty had a pure alcohol problem and of these 18 had a good outcome at follow up. Five had a mixed drug/alcohol problem; of these all were free from problem drinking and four had become abstinent from drugs at follow-up. Of the nine patients with a pure drug problems, eight were abstinent from drugs at follow-up. Given the retrospective nature of this study and the lack of control data, these results must remain impressionistic but the implications of the findings are discussed.     

Feigned insanity in nineteenth-century America: Tactics,trials, and truth

Feigned insanity in nineteenth-century America is appraised through a review of the medical and legal literature. The authors focus on the explanations for feigning, procedures used in uncovering feigning, and the role of feigning in the courtroom. This discussion of feigned insanity demonstrates the remarkable consistency of approach to this form of malingering over the past 200 years.     

The Interrupted Managerial Career Path: A Longitudinal Study of MBAs

The view of managerial career success as an uninterrupted climb up the corporate ladder no longer fits the realities of many managers. This study examined longitudinal data on the career paths of MBAs to determine the consequences of early- and mid-career gaps on career success. The study found that early gaps have a negative impact on income and management level. Gaps in mid-career also reveal an income penalty, even after controlling for pre-gap income. In mid-career, the negative level effect was found for women, but not for men. MBAs with discontinuous employment histories, however, did not have diminished career satisfaction. The research suggests the need for researchers, organizations, managers, and business schools to broaden the definition of acceptable managerial career paths.     

DIRECT AND COLLATERAL EFFECTS OF RESTRAINTS AND RESTRAINT FADING

Mechanical restraints are commonly used to reduce the risks associated with severe self-injurious behavior (SIB), but may result in movement restriction and adverse side effects (e.g., bone demineralization). Restraint fading may provide a method for decreasing SIB while increasing movement and reducing these side effects. In the current investigation, rigid arm sleeves and restraint fading (gradually reducing the rigidity of the sleeves) were used with 3 clients who engaged in hand-to-head SIB. Restraints and fading reduced the hand-to-head SIB of all clients. However, for 1 client, the addition of a water mist procedure further reduced SIB to near-zero levels. For a 2nd client, another form of SIB developed that was not prevented by the rigid sleeves. For a 3rd client, a topography of SIB that was not physically prevented by the rigid sleeves was also reduced when restraints and fading were introduced.     

BALANCING SOCIAL ACCEPTABILITY WITH TREATMENT EFFECTIVENESS OF AN INTRUSIVE PROCEDURE: A CASE REPORT

The debate over social acceptability of intrusive procedures has led some school districts to adopt policies allowing punishment for only the most extreme forms of destructive behavior. We investigated the effectiveness of selectively implementing punishment for only the most severe topographies of aggression and property destruction, while less extreme behaviors were ignored. Results indicated that severe behaviors were reduced to near-zero levels only when both severe and less severe behaviors were similarly punished.     

ACHIEVING AND MAINTAINING COMPLIANCE WITH THE KETOGENIC DIET

The ketogenic diet, a treatment for intractable epilepsy, is rarely initiated because it requires strict compliance with a diet that is perceived to be unpalatable. In a case study of a 15-year-old girl with uncontrolled epilepsy, we used a stimulus-choice procedure to assess relative preferences of 33 foods from the diet and to develop two treatments based on Premack's principle. The results of a multielement analysis showed that both treatments increased dietary compliance. Compliance was maintained with generalization of treatment across settings, and was associated with a 40% reduction in seizures.     

THE TREATMENT OF COVERT SELF-INJURY THROUGH CONTINGENCIES ON RESPONSE PRODUCTS

Assessment and treatment of covert self-injurious behavior are complicated because it is difficult to quantify and apply differential consequences to covert responses. In this study, both tangible and social reinforcers were identified using reinforcer assessment methods. These reinforcers were then provided contingent upon the absence of tissue damage identified during physical examinations, resulting in near 100% success in physical assessment checks that was maintained over 10 months.