Beyond home-based family intervention: A multi-family approach toward change

A growing specialty area in the mental health field involves working with emotionally disturbed youth and families-at-risk by providing services in the context of the home environment. A review of the literature provides documentation for family systems, social learning, and ecological interventions with at-risk families receiving home-based intervention but there is an absence of material on the use of multi-family groups with this population. The purpose of this article is to outline the implementation of a multi-family therapy (MFT) component for home-based programs serving at-risk families. Advantages and disadvantages when using MFT are also addressed.The authors are grateful to Linda Pannell for her helpful comments on drafts of this article.     

Predicting suicide using the Rorschach Inkblot Test

Three hundred and seventy-five Rorschach protocols were scored blind and then divided into three groups: psychiatric controls, suicide attempts, and suicide effectors. Using the stepwise procedure of multiple discriminant analysis a trio of formulas, composed of six weighted variables each, and a constant, were constructed to apply to each of the three groups based on a test sample of 100 subjects in each group. Cross validation results on a new sample of 25 subjects in each group predicted classification with 52% overall accuracy at step six (chance .33). Internal reliability tests showed all values significant beyond .001. Discussion integrates the test data into the literature on suicide, and attends to the problem of overlap of predictability which occurs with most prediction scales.     

2005 National Society of Genetic Counselors Presidential Address: Raising Our Voice

This Presidential Address was given at the annual education conference of the National Society of Genetic Counselors in Los Angeles, California, USA on November 14, 2005     

Dysfunctional isolation in the elderly: Increasing marital and family closeness through improved communication

Unique developmental crises in old age may lead to social withdrawal that negatively affects the individual and his/her marital and family relationships. Without an awareness of these aging dynamics, the therapist can inadvertently perpetuate these distancing behaviors which can exacerbate marital and family conflict. This paper discusses certain developmental crises which can result in increased isolation for the older adult, and suggests therapeutic interventions to facilitate increased closeness among family members.     

Recent Suicidal Ideation Among Patients in an Inner City Emergency Department

The rates and associated features of suicidal ideation among 5,641 patients seeking routine, nonsuicide related care in an inner‐city emergency department were examined. Approximately 8% of patients seeking routine care in the emergency department reported some form of suicidal ideation within the past 2 weeks. Suicidal ideation was common in individuals who were single with poorer mental health, had higher depression, and had received some drug or alcohol treatment in the past 3 months or had used cocaine or marijuana in the past 30 days. Improved screening procedures could help to identify routine care patients who are at risk for suicide.     

Characterization of the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) in Lung Transplant Candidates

The SIPAT is a standardized measure for pre-transplant psychosocial evaluation. Previous SIPAT studies utilized a relatively small lung transplant sample and only included listed patients. This study characterized the SIPAT in 147 lung transplant candidates to better elucidate its utility. The average score corresponded to a minimally acceptable rating and nearly half of the patients had relative or absolute contraindications. Interstitial Lung Disease (ILD) patients scored more favorably than non-ILD patients (U?=?7.69, p?<?.05). The Total (β?=?? .05, SE?=?.018, p?<?.01), Social Support Subscale (β?=?? .133, SE?=?.058, p?<?.05), and Psychosocial Stability and Psychopathology Subscale (β?=?? .103, SE?=?.040, p?<?.05) significantly predicted listing status. The SIPAT has a unique profile in lung transplant candidates and demonstrated utility for guiding transplant decisions. Future research should examine which lung transplant outcomes are significantly associated with SIPAT scores.

     

Self‐forgiveness: The Good,the Bad,and the Ugly

Traditionally, self‐forgiveness has been framed as a process that helps facilitate psychological as well as physiological well‐being following wrongdoing. In the present paper, we outline the limits and boundaries of this presupposition. Specifically, we outline contexts in which self‐forgiveness might yield negative consequence that include, among other things, a continuation of the wrongful behavior. First, we provide evidence that self‐forgiveness for ongoing, wrongful behavior (e.g., smoking) alleviates negative feelings associated with acknowledged wrongs committed by the self, which does little to motivate behavioral change. We then discuss the complication that is pseudo‐self‐forgiveness – a situation in which people shift some responsible away from the self for wrongs committed by the self. This outward shift in responsibility lets the self “off the hook”, which increases the likelihood that the wrongful behavior will continue. Drawing on these discussions, a path model for behavioral change that places self‐forgiveness at its core is offered. Although we present some pessimism regarding the outcome of the self‐forgiveness process, this paper points to situations and attributions that maximize its positive effects.