What we say we do: results of the 1997 UK Association of Family Therapy Members Survey

This study represents the first UK national survey of family therapists and systemic practitioners. The aim was to provide demographic information of systemic practitioners/family therapists and also to describe their clinical practice. The sampling frame used was the UK Association of Family Therapy membership list and all members were sent a postal questionnaire. The response rate was 33% with 495 out of 1500 questionnaires returned. Among the major findings were: systemic practitioners/family therapists are most likely to work for an NHS trust, to use family therapy techniques/systemic ideas predominantly, and to treat a broad range of client issues. They are also most likely to work with families, and therapy is relatively short term (five to eight sessions) regardless of whether they treat families, couples or individuals. Most family therapists/systemic practitioners use some measure of outcome, although frequently this will be feedback from clients. Supervision is sought by the majority of AFT members. In spite of some methodological limitations, the study provides interesting insights into the training and practice of UK family therapists and systemic practitioners which appears to differ in some respects from our American colleagues. It also provides a baseline for future surveys, making it possible to describe the developments of family therapy and systemic practice in this country.     

Primary Femininity and Female Genital Anxiety

The American Journal of Psychoanalysis -     

The Relationship Between Health and Human Services and the Personal Goal-Directed Activities of Persons Living with AIDS

This study evaluates the relationship between the social climate from different services and the personal goal-directed activities of 224 individuals with AIDS. The study's results supported the main hypothesis that recipient and participatory service involvement uniquely influence personal goal-directed activities, even after considering individuals with AIDS' physical symptoms, psychological distress, income, and recruitment site. Income and involvement with participatory services were both positively related to the amount of personal goal-directed activity. Longitudinal analyses suggest that personal initiative contributes to the subsequent amount of personal goal-directed activities a person pursues. These results suggest further examination of factors contributing to the selection of different service types and of the processes underlying the relationship between participatory services and positive outcomes for clients with AIDS.     

Mental Health, Social Environment and Sexual Risk Behaviors of Adolescent Service Users: A Gender Comparison

We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.     

The ‘Flexible’ Immigrant? Human Capital Discourse, the Family Household and Labour Market Strategies

As Canadian immigration policy increasingly selects ‘flexible’ immigrants based on their human capital, it correspondingly problematises immigrant families. In drawing on interviews, conducted over a 5-year period in two different neighbourhoods in the Greater Vancouver area, we followed the paths of family households that recently immigrated to Canada. We argue that households not only provide fundamental support in the migration process, but also enable immigrants to adopt flexible strategies to deal with precarious circumstances and thereby begin the process of integration. Rather than being a ‘problem’, immigrant households, and particularly women’s support roles within them, may be a critical lynchpin to successful integration.     

Integrating couples and family therapy into a community alcohol service: a pantheoretical approach

This paper discusses the contribution of family systems theory and therapy to mainstream alcohol treatment programmes. Systemic psychotherapy is integrated with group analytic psychotherapy in a couples and family therapy service within a community alcohol service (CAS) which uses the Prochaska and Diclemente model of stages of change. Problems and solutions in putting these complex ideas into practice are discussed, with specific reference to issues of engagement. An example of our work with a couple is offered to illustrate our weave of theory and practice.     

Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.     

Girls' and Boys' Changing Attitudes Toward School

This study considered children in kindergarten, first grade, and second grade in order to determine whether boys and girls differ from one another in their attitudes toward school when they first begin, and whether the relationship between boys' and girls' attitude changes with time. The information used in the study was collected during an evaluation of the California preschool program. A total of 6011 educationally disadvantaged children in 148 elementary schools were selected for the evaluation. The Attitude to School Questionnaire, developed at UCLA, was used to measure attitude. The study found that the sample of disadvantaged girls and boys has similar attitudes toward school in kindergarten. As they progress through the second grade, girls' attitude remains stable, while boys' attitude improves. The study also found that the differences between these attitude patterns were statistically significant. The study's results challenge the belief that girls have a better attitude toward school and suggest that differences in attitude between girls and boys develop between kindergarten and first grade.