Engaging African Americans in Therapy: Integrating a Public Policy and Family Therapy Perspective

The field of marriage and family therapy faces a growing imperative to reach historically underserved populations. African Americans are a prime example of a minority group in the United States that continues to be underserved by the current mental health system. We integrate Andersen’s (1995, Journal of Health and Social behavior, 36, 1–10) public policy model of health service use with Fox et al. (1995, Journal of Health Care for the Poor and Underserved, 6, 434–468) revision of the rural de facto mental health services model (Regier and Goldberg, 1978, Archives of General Psychiatry, 35, 685–693) to develop a more inclusive and culturally sensitive framework that captures salient factors influencing African Americans’ entry into and engagement in therapy. Recommendations for overcoming barriers and suggestions for future research are presented.     

Infant feeding and HIV in Sub-Saharan Africa: what lies beneath the dilemma?

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities.

A component analysis of behavioral skills training with volunteers teaching motor skills to individuals with developmental disabilities

This study included a component analysis of behavioral skills training (BST) for teaching volunteers how to use this training method to support individuals with developmental disabilities in a physical education program. In an alternating treatment design embedded within a multiple baseline design across five participants, the number of BST steps that volunteers completed correctly while teaching four motor skills was measured. In the initial training phase, each motor skill was taught to volunteers using a specific component of BST (i.e., instructions, modeling, rehearsal, or feedback). In subsequent training phases, BST components were combined to teach the volunteers the motor skills for which they did not reach a predetermined mastery criterion (a score of four correct responses across two consecutive trials). Maintenance was assessed. Results indicated that individual components of BST alone were sufficient for volunteers to meet the mastery criterion; however, the full BST framework was necessary for skill maintenance. Strengths, limitations, and recommendations for future research are discussed.     

Abusive supervision and workplace deviance and the moderating effects of negative reciprocity beliefs

In this study, the authors examine the relationship between abusive supervision and employee workplace deviance. The authors conceptualize abusive supervision as a type of aggression. They use work on retaliation and direct and displaced aggression as a foundation for examining employees' reactions to abusive supervision. The authors predict abusive supervision will be related to supervisor-directed deviance, organizational deviance, and interpersonal deviance. Additionally, the authors examine the moderating effects of negative reciprocity beliefs. They hypothesized that the relationship between abusive supervision and supervisor-directed deviance would be stronger when individuals hold higher negative reciprocity beliefs. The results support this hypothesis. The implications of the results for understanding destructive behaviors in the workplace are examined.     

Effects of age and divided attention on memory components derived for the category exemplar generation task

Age differences in memory performances on a conceptually driven task, the category exemplar generation (CEG) test, were investigated. Thirty-six younger adults and 36 healthy older adults studied word lists in full and divided attention conditions. Recall was tested with category names. The process-dissociation procedure was used to derive estimates of controlled and automatic memory. Old-old adults (70-84 years) exhibited poorer conscious recollection than both younger (18-24) and young-old adults (59-69). In contrast, no age differences were found in estimates of automatic memory. For the younger and older adults, the divided encoding manipulation reduced both the consciously controlled and automatic estimates of memory. The results suggest that the few prior findings of age deficits in priming on the CEG may have been an artifact of contamination from conscious retrieval processes. They also indicate that the opportunity for greater semantic processing enhances the conceptual priming of both younger and older adults.     

Social influence in pigeons (Columba livia): the role of differential reinforcement

Socially-influenced learning was studied in observer pigeons that observed a demonstrator in an adjacent chamber performing a target response comprising standing on a box and pecking a key 10 times. In Experiment 1 there was no evidence for social learning in the absence of reinforcement of the observer's behavior. When the target response was already established in the observer's repertoire, but was not differentially reinforced in relation to the demonstrator's behavior, rates of extinction were not influenced by the demonstrator's behavior (Experiment 2). Reinforcement of the observer's target response in the presence of the modeled target response, and not in its absence, resulted in control of the observer's responding by the behavior of the demonstrator (Experiments 3 and 4). This control was extended in Experiment 5 to deferred responses that occurred following a delay since the demonstrator's target responses. The acquisition of social influence depended on differential reinforcement of the observer's target response, with the demonstrator's target behavior serving as the explicit discriminative stimulus.     

Using Structural Analysis in Natural Settings: A Responsive Functional Assessment Strategy

Since the reauthorization of IDEA (1997), the use of functional assessments to examine factors that are related to students challenging behaviors has gained increasing attention in the literature. Over the past five years, several groups of investigators have conducted systematic analyses of the current status of the use of functional assessment in relation to students with or at risk for emotional/behavioral disorders (EBD). Their findings outline a number of critical, applied research issues for the field to consider. The purpose of this paper is to respond to a number of these issues by highlighting the relevance of structural analysis in addition to and in some cases in lieu of more traditional functional assessments. A brief review of current trends in the functional assessment research is presented as well as a rational for the use of structural analysis to examine the occurrence of appropriate behavior for students with EBD. Finally, illustrations of studies conducting structural analyses in classrooms settings are provided.     

Virtual environments for motor rehabilitation: review.

In this paper, the current "state of the art" for virtual reality (VR) applications in the field of motor rehabilitation is reviewed. The paper begins with a brief overview of available equipment options. Next, a discussion of the scientific rationale for use of VR in motor rehabilitation is provided. Finally, the major portion of the paper describes the various VR systems that have been developed for use with patients, and the results of clinical studies reported to date in the literature. Areas covered include stroke rehabilitation (upper and lower extremity training, spatial and perceptual-motor training), acquired brain injury, Parkinson's disease, orthopedic rehabilitation, balance training, wheelchair mobility and functional activities of daily living training, and the newly developing field of telerehabilitation. Four major findings emerge from these studies: (1) people with disabilities appear capable of motor learning within virtual environments; (2) movements learned by people with disabilities in VR transfer to real world equivalent motor tasks in most cases, and in some cases even generalize to other untrained tasks; (3) in the few studies (n = 5) that have compared motor learning in real versus virtual environments, some advantage for VR training has been found in all cases; and (4) no occurrences of cybersickness in impaired populations have been reported to date in experiments where VR has been used to train motor abilities.