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.     

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.     

Intergroup fairness and bias in children

In recent years in research on intergroup relationships, the assumption has increasingly been made that discrimination dominates decisions when individuals allocate resources between (members of) own and other group. Conversely, in empirical studies of interpersonal decision-making, including an extensive literature on the development of children's allocation rules within dyadic relationships, it has been repeatedly observed that in dyadic relationships choices though responsive to various changes in the environment, are more strongly governed by fairness rules. The present research extends the interpersonal fairness paradigm to the intergroup case, and examines the effects of some of those variables, namely, children's age, input and attitudes toward other, that have been observed to influence choice behaviour within interpersonal relationships. The findings indicate that as children are socialized, fairness rules also play an increasing dominant role in intergroup allocation decisions, and that both relative input and the language of the outgroup influence such decisions. At the same time, there is some preliminary evidence to indicate that the relative strength of self-interest may be somewhat stronger in intergroup than in interpersonal relationships. Finally, a number of the issues that must be confronted in comparing the two more important forms of human social choices, interpersonal and intergroup decision-making, are considered.     

Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.