Some Historical Conditions of Narrative Work

Written to honor the immense contribution of Michael White as a leader in the development of narrative therapy, this historical essay contrasts the origins of psychoanalysis, family therapy and narrative therapy. Changes in the understanding of therapeutic strategies, methods of training and supervision, styles of leadership, the involvement of audiences in the therapeutic and training processes, and conceptions of the nature of the mind are described. A style of direct demonstration of methods, especially of the formulation of questions, is important in narrative work. The central master-role of the therapist in analysis and family therapy is replaced in narrative work by eliciting local knowledge, and the recruitment of audiences to the work. This is consistent with narrative therapy's "de-centered" image of the therapist.     

The impact of family and peer differentiation levels on adolescent psychosocial development and problematic behaviors

This study examined the impact of family differentiation and peer differentiation levels on adolescent problematic behaviors and psychosocial maturity. Differentiation levels were assessed dyadically in both the family and peer systems. Results revealed family differentiation to be the sole predictor of adolescent problematic behavior. Additional regression analysis indicated that peer differentiation was a significant predictor of psychosocial maturity, along with the significant impact of adolescent gender and age. Family X Peer interaction terms were not significant predictors of either adolescent personal adjustment variable. Results, whichdisplay both consistencies and variations with the findings of previous research, are discussed in terms of their clinical implications.Salary and support provided in part by grants from The Kettering Fund (OSURF #727033) and by The Ohio State University (OSURF #221424 and OSURF #241501).     

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.     

Life Skills: Adolescents' Perceptions of Importance and Competence

A previous classification of life skills was used to suggest issues relating to areas of adolescents' concerns involving relationships, leisure, jobs, education, preparation for the future, work, budgeting, health, social responsibility, and personal skills such as planning and decision-making. A questionnaire relating these concerns to young people's perceptions of the facets of importance, and their own knowledge, competence, sense of improvement, problems, and striving, was administered to a sample of 1,084 adolescents in senior schools and colleges of technical and further education. The results suggested a strong general factor for each facet, with some differentiation into groups of skills. The mean ratings suggested that the skills investigated were considered to be very important by young people, who in general also seemed optimistic about their competence. However, a small proportion expressed serious problems. Responses to the various facets were further examined in terms of group differences — by age, gender, educational context, ethnicity, economic status, and educational expectations. Many small but significant group differences were isolated. Finally, implications are drawn from this related research for schools and colleges in general and for guidance and counselling in particular.     

Behaviour patterns within a general hospital psychiatric unit: an observational study.

Employing a reliable and objective ‘behavioural mapping’ procedure, information was obtained by three independent observers, on what, where and when staff and patients engaged in various categories of behaviour, within a general hospital psychiatric unit. Observations were undertaken during two separate 6-day periods, using a seven category behaviour rating scale. Staff and patient behaviour profiles were found to be stable across the two rating periods, despite an almost complete change in the patient population from the first to the second set of observations. Results also indicated that staff spend a majority of their time engaged in interaction with their peers, or engaged in solitary task activity, with little of their time being spent in interaction with patients. Patients spent approximately half of their time in solitary behaviour, and when they were observed to be interacting it was found to be primarily with their peers. A significant negative correlation was obtained between those areas of the unit most frequently occupied by staff and patients, suggesting a territorial separation of the two groups. Analysis, of interaction rates by time, further indicated that the vast majority of interaction was observed to occur during the period 9.00a.m. to 5.00p.m. Monday to Friday. Some implications of the observed findings are discussed and it is concluded that the data suggest that the therapeutic potential of the observed unit is under-utilized.     

Behavioural analysis of ward rounds within a general hospital psychiatric unit.

A naturalistic observational procedure was used to examine the content of staff verbal interaction during the ward rounds of two inpatient teams in a general hospital psychiatric unit. Observers reliably rated staff discussion of 10 neurotic and 10 psychotic inpatients, using a nine category behavioural scale. The major focus of this scale was the extent to which three broad orientations, viz the medical, psychotherapeutic and sociotherapeutic models, were utilized by the staff. It was found that an eclectic approach was used by staff in their discussion of patients' aetiology, treatment and prognosis. However, the medical model was primarily utilized to formulate patient care, with the sociotherapeutic approach being employed for approximately one-third of the time. The psychotherapeutic orientation was only used 2.9% of the total time that patients were discussed. This pattern of use of the three orientations was consistent across the psychotic and neurotic patient groups. The behavioural data were found to be at variance with the degree to which staff believed the models should be applied. Analysis of the amount of time during which each professional group spoke in the ward rounds, and the rate at which they were found to make denned ‘authority statements’, indicated that a hierarchical model of management operated in the unit. These findings are related to the concept of shared power and responsibility within the therapeutic team.     

AN EMPIRICAL METHOD FOR DETERMINING AN APPROPRIATE INTERVAL LENGTH FOR RECORDING BEHAVIOR

The study sought to examine the effects of varying interval length on the representation of data obtained using modified frequency time sampling. A 7-category scale was used to observe reliably the behavior of eight psychiatric inpatients. Using electronic real time recording equipment, it was possible to computer analyze the obtained data at varying interval lengths, the shortest interval being 1.0 seconds. It was found that increasing the interval length had little effect on the percentage of total duration recorded within each behavioral category, suggesting that this is a relatively stable measure of behavior. Percentage total events for each category was less stable with increasing interval lengths. The number of recorded events within each category tended to decrease, while their average durations tended to increase, as a function of increasing the interval length. The data suggest that the current practice of determining interval length in an arbitrary fashion, or on the basis of convention, should be abandoned. Rather, such a decision should be empirically determined for each particular observation scale and subject group. One method by which this might be achieved is presented.     

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