Recent developments in family behavioral marital therapy

This paper reviews recent developments in the area of behavioral marital therapy (BMT). New information is summarized regarding the long-term efficacy of BMT and the identification of predictors of positive response to treatment and to relapse. Finally, new applications of BMT techniques are reviewed (e.g., spouse-involved therapies as the sole treatment for presenting problems in which marital distress is not the primary focus such as anxiety and affective disorders).     

The rapid-smoking technique: Some physiological effects

The effects of rapid smoking on the blood pressure, pulse rate and cardiac functioning of 58 smokers (30 women and 28 men) are reported. All subjects were healthy volunteers, 45 were under 40 yr of age, the remaining 13 between 40 and 50 yr. They received between 6 and 12 rapid smoking sessions. It was found that, in both the under and over 40 age groups, blood pressure levels and pulse rates increased significantly following rapid smoking sessions. There were, however, significant decreases between sessions and no evidence of a cumulative effect of successive rapid smoking sessions. Some qualitative changes in cardiac functioning were observed, namely the appearance of T wave flattening and S-T depression. None of the changes were considered to be of sufficient magnitude to necessitate exclusion from the programme, but confirm the need to monitor closely the physiological functioning of persons undergoing rapid smoking.     

Documentary Bioethics: Visual Narratives for Generations X and Y

Narrative bioethics is primarily understood to involve storytelling through the use of literature. This article suggests that other forms of media are necessary to convey stories of an ethical nature to an audience broader than one being trained as medical professionals. "Documentary bioethics" is a manner to present and interpret stories of an ethical nature using forms of popular electronic media in a reality-based documentary style to society at large, specifically Generations X and Y.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Reducing child witnesses' false reports of misinformation from parents.

This study explored whether a source-monitoring training (SMT) procedure, in which children distinguished between events they recently witnessed versus events they only heard described, would help 3- to 8-year-olds to report only experienced events during a target interview. Children (N = 132) who witnessed science demonstrations and subsequently heard their parents describe nonexperienced events received SMT before or after a forensic-style interview. SMT reduced the number of false reports that 7- and 8-year-old children reported in response to direct questions but had no impact on the performance of younger children. Combined with earlier results, these data suggest a transition between 3 and 8 years of age in the strategic use of source-monitoring information to support verbal reports, such that only 7- and 8-year-olds generalize training to a difficult memory task that does not include mention of specific alternative sources.     

Children's eyewitness reports after exposure to misinformation from parents

This study examined how misleading suggestions from parents influenced children's eyewitness reports. Children (3 to 8 years old) participated in science demonstrations, listened to their parents read a story that described experienced and nonexperienced events, and subsequently discussed the science experience in two follow-up interviews. Many children described fictitious events in response to open-ended prompts, and there were no age differences in suggestibility during this phase of the interview. Accuracy declined markedly in response to direct questions, especially for the younger children. Although the older children retracted many of their false reports after receiving source-monitoring instructions, the younger children did not. Path analyses indicated that acquiescence, free recall, and source monitoring all contribute to mediating patterns of suggestibility across age. Results indicate that judgments about the accuracy of children's testimony must consider the possibility of exposure to misinformation prior to formal interviews.     

Individual differences in working memory capacity and visual search: The roles of top-down and bottom-up processing

Individual differences in working memory capacity (WMC) have been implicated in a variety of top-down, attention-control tasks: Higher WMC subjects better ignore irrelevant distractions and withhold habitual responses than do lower WMC subjects. Kane, Poole, Tuholski, and Engle (2006) recently attempted to extend these findings to visual search, but found no relation between WMC and search efficiency, even in difficult tasks yielding steep search slopes. Here we used a visual search task that isolated the contributions of top-down versus bottom-up mechanisms, and induced a habitual response via expectation. Searches that relied primarily on bottom-up mechanisms did not vary with WMC, but searches that relied primarily on top-down mechanisms showed an advantage for higher over lower WMC subjects.     

The Significance of Strategic Community Engagement in Recruiting African American Youth & Families for Clinical Research

We present baseline data and describe the utility of a community engaged, culturally relevant approach to recruiting African American youth and families for phase I of The AAKOMA Project. The AAKOMA Project is a two phase treatment development study to improve mental health service use among depressed African American youth. We completed capacity building activities using a community engaged framework and Community Based Participatory Research (CBPR) methods. Replicating the (Alvarez et al. in West J Nurs Res 28:541–560, 2006) model of systematic community outreach enhanced our ability to effectively recruit partners and evaluate outreach efforts as demonstrated by our Recruitment Success Factor (RSF—i.e. ‘an adjusted ratio of eligible participant yield to contacts made’). Using the chi-square goodness-of-fit statistic; we compared the RSFs of the various modes of participant study entry to determine which was most effective. Our target enrollment was 56 persons. We recruited 130 and enrolled 57. Our baseline data is drawn from a gender balanced and socioeconomically diverse sample who participated in youth focus groups and individual interviews and adult focus groups. We identified 3 study participant referral modes (self-referral, provider referral and participant-to-participant referral) with multiple sources per mode and an overall RSF of 0.41. Study findings support the effectiveness of assiduous and systematic community interaction, reflective review of recruitment efforts and the importance of disseminating information on strategic recruitment processes for engaging diverse populations in clinical research.     

A Multi‐Family Group Intervention for Adolescent Depression: The BEST MOOD Program

Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self‐harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual‐level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi‐family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.