Potential Perils of the Demonstration-Consultation Interview in Family Therapy: A Case Study of Contextual Confusion

This article focuses on a specific aspect of consultation in contemporary family therapy, namely, problems that arise in the context of a consultation that simultaneously serves as a demonstration of a particular model of therapy. The demonstration-consultation interview is used widely in family therapy, but has received little attention in the literature. We use a case example of the apparent persistent deterioration in the clinical state of a patient following such a family interview with a visiting expert, and examine the possible contribution to the patient's deterioration that the demonstration-consultation context creates for the various participants. We offer provisional guidelines to minimize the risk of negative effects of the demonstration-consultation interview, pending empirical research into this phenomenon.     

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study

In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.     

Adolescent Smoking Behavior and the Recognition of Cigarette Advertisements1

In a study designed to assess the relationship between smoking status and correct identification of cigarette brands, junior high school students from two schools viewed cigarette and automobile advertisements with brand and model identification deleted. Results showed that adolescents with higher ad recognition scores were more likely to smoke cigarettes. In addition, a relationship was found between age and correct identification of cigarette advertisements, with older students identifying more ads correctly than younger students. No significant effects emerged for identification of automobile advertisements except for sex, with boys identifying more advertisements than girls. Additional findings indicated that even “experimental” smokers, who smoked as little as once per year, recognized significantly more cigarette advertisements than nonsmokers. These and other results are discussed in terms of their implications for prevention and policy issues. It is argued that society's allowance of printed cigarette advertising overlooks adolescents' heightened vulnerability to the kinds of appeals used in cigarette advertisements. Present policy also overlooks adolescents' relative unresponsiveness to the health risk information required in cigarette advertisements.     

Teaching cotherapy: Instructional and supervisory processes

A course on cotherapy for mental health practitioners is described. The authors strongly recommend that clinicians from all disciplines be taught and trained to do cotherapy, since it is a highly effective therapeutic modality in treating individuals, families and groups.     

The use of guided imagery in psychotherapy: Modules for use with passive relaxation training

Passive relaxation training can be an important technique when conducting psychotherapy with anxiety disorder clients. A central element of the passive relaxation process is the use of guided imagery. The clinical use of imagery is verbally guided by the therapist and includes multiple sense modalities. The exact procedures used in guided imagery are not often described in adequate detail. An appendix is included to describe five guided imagery modules to be used in combination with the passive relaxation procedures.     

The self in transformation: Dialectical processes in long-term psychotherapy

A number of phases are notable during the process of integration of the self through psychotherapy. Each of these phases encompasses a particular ontology in relation to the dynamic self. The underlying process of change, moreover, may be conceived of as dialectical in nature with each phase having a unique thesis and antithesis. A clinical case is presented to illustrate these ideas for the therapist.     

Preschoolers' construction order of event sequences related to mental ability and degree of familiarity.

Preschoolers' understanding of sequential relations was investigated in two experiments. Experiment 1 showed that appreciation of sequential relations depends on the level of mental ability and the degree of familiarity displayed with the social or behavioral phenomena under investigation. Experiment 2 reproduced the findings of Experiment 1 and, further, demonstrated that an increase in experience and familiarity through an interaction phase between children with higher and those with lower mental abilities led to a significant exchange of information and performance that was retained over the posttest phase. The data of both experiments are discussed within the framework of the "invariance hypothesis" (Bullock, 1985) in contrast to Piagetian theory (Piaget, 1946/1969).     

Courtesy stigma: the social implications of associating with a gay person

We investigated the operation of courtesy stigma with American male college students who reacted to a fictitious male student described as gay, rooming by choice with a gay male student, involuntarily assigned to room with a gay, or rooming with a male heterosexual. Among respondents who expressed strong intolerance of gays, the voluntary associate of a gay was perceived as having homosexual tendencies and as possessing the same stereotyped personality traits attributed to a gay. No such courtesy stigma was attached to the involuntary associate of a gay by these respondents. Relatively tolerant respondents engaged in no courtesy stigmatization at all. Thus, courtesy stigmatization occurred only under circumscribed conditions and appeared to depend more on the tendency of highly intolerant individuals to infer that a male student who apparently liked a gay individual was himself gay than on a motivation to maintain cognitive consistency.