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The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*
Ellen Pulleyblank Coffey Ph.d. Mary E. Olson Ph.d. Phebe Sessions Ph.d. 《Family process》2001,40(4):385-399
This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care. 相似文献
234.
Mary Beth Rosson 《Memory & cognition》1985,13(1):90-99
Two experiments examined the role of pronunciation rules and of lexical information in pronouncing letter strings. In Experiment 1, subjects pronounced pseudowords varying in the strength of the rules needed to pronounce them, as well as in the availability of a lexical model. In Experiment 2, the stimuli were words varying in rule strength and in usage frequency. The pronunciation times from both experiments displayed an interaction between rules and lexical information: When the rules necessary were strong, the relative availability of lexical information was less important than when the rules were weak. The results were discussed with respect to both traditional dual-process models of pronunciation and models proposing the use of lexical analogies. 相似文献
235.
McDonald R Dodson MC Rosenfield D Jouriles EN 《Journal of abnormal child psychology》2011,39(7):1013-1023
This study examined whether Project Support, a parenting intervention shown to reduce child conduct problems, also exerts
positive effects on features of psychopathy in children. Participants were 66 families (mothers and children) recruited from
domestic violence shelters who participated in a randomized controlled trial evaluating Project Support. Each family included
at least one child between the ages of 4 and 9 who was exhibiting clinical levels of conduct problems. Families were randomly
assigned to the Project Support intervention condition or to an existing services comparison condition, and they were assessed
on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition,
compared with those in the comparison condition, exhibited greater reductions in features of psychopathy. Moreover, the changes
in features of psychopathy remained after accounting for changes in conduct problems. Project Support’s effects on features
of psychopathy were mediated by improvements in mothers’ harsh and inconsistent parenting. These findings on the effects of
an intervention on features of psychopathy are the first from a randomized controlled trial. They inform the debate about
whether features of psychopathy in children are responsive to intervention, and hold important implications for clinical practice. 相似文献
236.
Mary M. Smyth Norma A. Pearson Lindsay R. Pendleton 《The Quarterly Journal of Experimental Psychology Section A: Human Experimental Psychology》1988,40(3):497-514
Five experiments are reported in which subjects were asked to remember short, visually presented sequences of whole body movement patterns, words, and spatial positions. The items were recalled in order in a memory span paradigm. During presentation of the items to be remembered subjects simply watched, or they carried out a concurrent activity involving articulatory suppression, movement to external spatial targets, or body-related movement. When the movement patterns to be remembered were familiar to subjects, movement span was not disrupted by articulatory suppression or movement to spatial targets but was disrupted by body-related movement. This movement suppression task, however, did not interfere with performance on a spatial span task or on verbal span. It is concluded that the memory for patterns of limb movement differs from memory for movement to spatial targets and that accounts of visuo-spatial processes in working memory involve the latter type of movement. 相似文献
237.
Salience network response to changes in emotional expressions of others is heightened during early adolescence: relevance for social functioning 下载免费PDF全文
Maya L. Rosen Margaret A. Sheridan Kelly A. Sambrook Meg J. Dennison Jessica L. Jenness Mary K. Askren Andrew N. Meltzoff Katie A. McLaughlin 《Developmental science》2018,21(3)
Adolescence is a unique developmental period when the salience of social and emotional information becomes particularly pronounced. Although this increased sensitivity to social and emotional information has frequently been considered with respect to risk behaviors and psychopathology, evidence suggests that increased adolescent sensitivity to social and emotional cues may confer advantages. For example, greater sensitivity to shifts in the emotions of others is likely to promote flexible and adaptive social behavior. In this study, a sample of 54 children and adolescents (age 8–19 years) performed a delayed match‐to‐sample task for emotional faces while undergoing fMRI scanning. Recruitment of the anterior cingulate and anterior insula when the emotion of the probe face did not match the emotion held in memory followed a quadratic developmental pattern that peaked during early adolescence. These findings indicate meaningful developmental variation in the neural mechanisms underlying sensitivity to changes in the emotional expressions. Across all participants, greater activation of this network for changes in emotional expression was associated with less social anxiety and fewer social problems. These results suggest that the heightened salience of social and emotional information during adolescence may confer important advantages for social behavior, providing sensitivity to others’ emotions that facilitates flexible social responding. 相似文献
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Research on dynamic stereotypes of women has shown that women perceive large differences between contemporary women and women who lived in the past in terms of agentic (or masculine) traits. This temporal discrepancy in agentic attributes of women may suggest that agency is not a stable trait of women and may result in impaired performance in domains associated with agency, such as quantitative reasoning. We propose that women who think that agency has always characterized their gender group would perform better in quantitative tasks. Indeed, we found that as the difference between agency attributed to present and past women decreased, U.S. college women’s (n?=?80) accuracy in a quantitative test increased (Study 1). Further, reading a text about women’s achievements in the history of science reduced the discrepancy between agency attributed to past and present women and had an indirect positive effect on quantitative performance by 150 U.S. college women (Study 2). Findings suggest that women’s participation and performance in science could be improved by raising awareness of women’s historical achievements in male-dominated areas. 相似文献
240.
The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individual's decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patients' autonomy, characteristic of most other operative interventions. In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patients' autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patients' autonomy. We further suggest that if living organ donation valued donors' autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation. 相似文献