The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

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.     

Local Opposition to the Construction of a Nuclear Power Station: Differential Salience of Impacts1

This study examined attitudes among 290 residents of three villages in South-West England toward proposals to build a nuclear power station nearby. Respondents were split into four groups according to whether they were neutral or in favor of a new power station either locally or elsewhere in the UK (Group PN), against one locally but neutral or pro elsewhere (LO), or moderately (MO) or extremely (XO) against a new power station both locally and elsewhere. The perceived impact of a nuclear power station on local life was assessed by 30 items. The PN group expected most benefit or least damage on all 30 items. On a majority of items the mean ratings of the LO group resembled those of the XO's more than did those of the MO's. A stepwise discriminant analysis yielded two interpretable functions. The first reflected a trend over the groups in the order PN-LO-MO-XO and was marked particularly by concern with impact on personal peace of mind. The second fuction discriminated the LO's from the other groups, suggesting that they were relatively less concerned with specifically nuclear risks, but more concerned with environmental conservation.     

A COMPARISON OF PEER-DIRECTED AND TEACHER-DIRECTED EMPLOYMENT INTERVIEW TRAINING FOR MENTALLY RETARDED ADULTS

Interview skills deficits may limit employment prospects of mentally retarded adults. Although numerous papers highlight the importance of interview skills, few have validated effective strategies for use with mentally retarded persons. Further, there has been a lack of research contrasting rival interview skills training strategies. The present study was conducted with two mentally retarded young adults. It contrasted peer-directed instruction, in which both participants were equally deficient in the target skills, with teacher-directed instruction. Results of the investigation indicated that instruction, rehearsal, and feedback may be effective strategies regardless of who provides instruction. Comparisons of teacher-directed and peer-directed instruction indicated little or no difference in the effectiveness of the two procedures. However, the peer-directed procedure involved considerably less staff time than did the teacher-directed procedure.     

Processing resources and age differences in working memory

This study investigated the performance of young and old subjects on a modified version of the working memory task developed by Baddeley and Hitch (1974). Subjects were required to verify a set of sentences of varying complexity while they repeated aloud zero, two, or four words. The older subjects took longer to verify the sentences, especially when the sentences were grammatically complex, but the effect of concurrent memory load on verification latency was the same in both groups. These results cast doubt on the notion that there is an age-related decline in one general pool of processing resources. They also suggest that older people have greater difficulty with the active processing aspects, rather than with the passive holding aspects, of working memory tasks.     

Reduced intergroup differentiation as a result of self-categorization in overlapping categories. A quasi-experiment

A quasi-experiment was conducted to examine the effects of self-categorization in overlapping categories on intergroup differentiation. ‘Old aged women’ was used as the first, ‘sports’ as the additional category. It could be shown that intergroup differentiation was significantly reduced under crossed categorization conditions. Implications for social compensation strategies are discussed.     

Maternal depression and its relationship to life stress,perceptions of child behavior problems,parenting behaviors,and child conduct problems

This study examined the relationship of reported maternal depression to prior and current life stressors, and to mother perceptions of child adjustment, parenting behaviors, and child conduct problems. Forty-six depressed mothers and 49 nondepressed mothers and their clinic-referred children (aged 3-8 years) participated. Depressed mothers were more critical than nondepressed mothers, but the behavior of children of depressed and nondepressed mothers showed no significant differences. Depressed mothers were more likely to have experience child abuse, spouse abuse, or more negative life events than nondepressed mothers. Maternal reports of stress related to mother characteristics and to negative life events were the most potent variables discriminating depressed from nondepressed mother families.     

Subject knowledge of the Experimenter''s interest in handedness and familial sinistrality variables and laterality test outcomes

We investigated the possible influence of common "demand characteristics" on the results on behavioral language laterality tasks. The demand characteristics were (1) whether Ss were or were not recruited for study according to their handedness, and (2) whether a detailed familial sinistrality inquiry was conducted before or after the tasks. Tasks were the Dichotic Consonant Vowel Task (DCVT) and the Bilateral Object Naming Latency Task (BONLT). Results showed no effect of demand characteristics on the BONLT. On the DCVT, however, prior inquiry regarding familial sinistrality was associated with significantly reduced right ear advantages (REAs). Interactions showed that the greatest reduction in REAs occurred in Ss with left-handedness in their families, who were asked about familial sinistrality prior to the tasks, who took the DCVT after the BONLT, and who were also recruited by handedness. Results, though generally reassuring regarding the robustness of the tasks against these sources of bias, raise some cautions for the DCVT.     

Interactions between area and numerosity

Summary The concept of filled area, i.e. the impressionistic ensemble of parts of a stimulus field occupied by dots, is used to account for various kinds of numerosity illusions due to perceptual interaction between a number of dots and their spatial arrangement. A measure of filled area is derived from a model for the perceptual clustering of dots on the basis of relative proximity. It is shown that the quantified concept of filled area successfully predicts illusion data from earlier studies. Subsequently, a two-alternatives forced-choice numerosity experiment is reported, the data of which gave further evidence of the predictive power of the filled-area hypothesis. Our approach is discussed with respect to spatial features of dot stimuli that might be in rivalry with the filled-area factor in numerosity-estimation tasks.