The Challenges of Intercultural Marriage: Strategies for Pastoral Care

In this article, the author describes the unique issues associated with intercultural marriage. A case illustration provides the springboard for presenting specific pastoral care and counseling strategies that may be helpful to intercultural couples. These strategies include assessing worldview and acculturation, creating spiritual and cultural genograms, reframing cultural challenges, collaborating with indigenous healers, inventing new rituals, and developing the advocacy role.     

Change in maternal criticism and behavior problems in adolescents and adults with autism across a 7-year period

In a previous study, high levels of maternal criticism predicted increased behavior problems in adolescents and adults with autism spectrum disorders (ASD) over an 18-month period (Greenberg, Seltzer, Hong, & Orsmond, 2006). The current investigation followed these families over a period of 7 years to examine the longitudinal course of criticism and behavior problems, to assess the association between their trajectories, and to determine the degree to which change in each of these factors predicted levels of criticism and behavior problems at the end of the study period. A sample of 118 mothers coresiding with their adolescent and adult children with ASD provided open-ended narratives about their children and reported on the children's behavior problems at 4 waves. Maternal criticism was derived from expressed emotion ratings of the narratives. Criticism exhibited low but significant stability over the 7-year period, and behavior problems exhibited high stability. Through latent growth curve modeling, (a) criticism was found to have increased over time, but only for the group of families in which the sons or daughters transitioned from high school services during the study period; (b) individual changes in criticism and behavior problems were positively correlated over the 7-year period; and (c) changes in criticism predicted levels of behavior problems at the conclusion of the study. Changes in behavior problems were not predictive of end levels of criticism. Implications for intervention and prevention efforts are discussed.     

Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls.

The authors tested whether physical self-concept and self-esteem would mediate cross-sectional relations of physical activity and sport participation with depression symptoms among 1,250 girls in 12th grade. There was a strong positive relation between global physical self-concept and self-esteem and a moderate inverse relation between self-esteem and depression symptoms. Physical activity and sport participation each had an indirect, positive relation with global physical self-concept that was independent of objective measures of cardiorespiratory fitness and body fatness. These correlational findings provide initial evidence suggesting that physical activity and sport participation might reduce depression risk among adolescent girls by unique, positive influences on physical self-concept that operate independently of fitness, body mass index, and perceptions of sports competence, body fat, and appearance.     

Long-acting reversible contraception: A route to reproductive justice or injustice

This article presents information on unintended pregnancies and the ongoing efforts of policy makers to promote long-acting reversible contraception (LARC) to reduce the numbers of such pregnancies. Also discussed is the tension between the encouragement of LARC to promote the public's interests in achieving that goal versus the need to assure that all women can decide about their bodies and reproductive needs. Our discussion includes information, primarily from the United States, on (a) risks associated with unintended pregnancies, (b) LARC devices approved in the United States (copper intrauterine devices (IUDs), hormone IUDs, and implants), (c) public and social benefits of increasing the use of LARC, (d) disadvantages and barriers to using LARC, (e) dangers of promoting LARC in unjust ways, and (f) the meaning of reproductive justice and its connection to social justice. By sharing the information with the audience of this journal, we hope that it will be integrated into clinical work and research on mental health and development. We also hope that experts in those fields will become discussants in the conversation regarding women's reproductive health and social justice that is taking place in the United States and elsewhere.     

Creating “Maneuvering Room”: A Grounded Theory of Language and Influence in Marriage and Family Therapy

Influence in psychotherapy has been described as a characteristic of the therapist, a characteristic of the therapeutic relationship, and a negotiated process. This study combines grounded theory and task analysis to explore language patterns in facilitating change in family therapy. Thirty-one episodes of therapy were analyzed, resulting in the emergent concept of creating maneuvering room. Therapists introduce uncertainty into clients beliefs about problems then offer new ways of defining problems by speaking from three dimensions: therapist as expert or non-expert, therapist as participant or observer, or family members experiences as similar or different. The findings of this study support a possible common factor in family therapy.     

Trajectory of development in adolescents and adults with autism

This article seeks to elucidate the trajectory of development in adolescents and adults with autism. Prospective, retrospective, and cross-sectional studies are reviewed to reveal the manifestation of and changes in the core symptoms of autism in adolescence and adulthood. Comparing children with adolescents and adults, modest degrees of symptom abatement and improvement in skills have been documented in multiple studies, as are increases in verbal and decreases in performance IQ. Nevertheless, most individuals do not attain normative outcomes in adulthood and continue to manifest significant degrees of symptomatology and dependency. However, a small sub-group (about 15%) has more favorable adult outcomes.     

Does class size in first grade relate to children's academic and social performance or observed classroom processes?

This study evaluated the extent to which first-grade class size predicted child outcomes and observed classroom processes for 651 children (in separate classrooms). Analyses examined observed child-adult ratios and teacher-reported class sizes. Smaller classrooms showed higher quality instructional and emotional support, although children were somewhat less likely to be engaged. Teachers in smaller classes rated typical children in those classes as more socially skilled and as showing less externalizing behavior and reported more closeness toward them. Children in smaller classes performed better on literacy skills. Larger classrooms showed more group activities directed by the teacher, teachers and children interacted more often, and children were more often engaged. Lower class sizes were not of more benefit (or harm) as a function of the child's family income. First-grade class size in the range typical of present-day classrooms in the United States predicts classroom social and instructional processes as well as relative changes in social and literacy outcomes from kindergarten to first grade.     

Improving day-treatment services for adults with severe disabilities: a norm-referenced application of outcome management

We evaluated an outcome management program for working with staff to improve the performance of adults with severe disabilities in a congregate day-treatment setting. Initially, observations were conducted of student task involvement and staff distribution of teaching interactions across students in four program sites. Using recent normative data to establish objective goals for student performance, management intervention was warranted in two of the sites. A six-step outcome management program was then implemented in the two sites. The program involved defining desired student and staff outcomes, systematic monitoring of the outcomes, staff training, and supportive and corrective feedback. The outcome management program was accompanied by increases in student on-task behavior and staff distribution of teaching interactions in both sites. The increases brought the levels of on-task behavior above the normative average; on-task behavior was maintained above the baseline average for over 1 year in both sites. These results are discussed in terms of the benefits of relying on normative data for objectively evaluating and improving service delivery systems. Discussion of future research needs focuses on applying the outcome management program to other settings and services for people with disabilities.