Engaging “Resistant” Families in Treatment

Many families, when presented with the option of family therapy, are less than eager to participate. This paper comprises the second and third parts of a series on engaging “resistant” families. ¹ 1 The first paper in this series, authored by J. M. Van Deusen, M. D. Stanton, S. M. Scott, and T. C. Todd, is entitled “Engaging “Resistant” Families in Treatment: I. Getting the Drug Addict to Recruit His Family Members” and appeared in the International Journal of the Addictions 15 (7): 1069–1089, 1980. A revised and expanded version of Part II is presented in M.D. Stanton, T. C. Todd, and Associates, The Family Therapy of Drug Abuse and Addictions New York, Guilford, in press.
Part II presents 21 principles and a number of techniques and strategies that have been developed for successfuly recruiting such families. These techniques should be applicable for engaging resistant families with all types of presenting problems. Part III provides an analysis of the important variables involved, along with data on cost efficiency and administrative costs. It was found that when therapists had administrative control of their cases, serving in dual roles as both therapists and drug counselors, the recruitment effort was (a) more effective (i.e., complete families, including both parents or parent surrogates, were recruited in 77 per cent of the cases), and (b) twice as cost efficient. Two-thirds of the non-engaged families were not recruited because the index patient would not allow family members to be contacted. Black families were more difficult to recruit than whites. Data on cost efficiency and on the actual administrative costs of recruiting families are also provided. We conclude that the engagement process requires a revision in therapeutic philosophy, since such families are often desperately in need of help but are unavailable unless therapists make a special effort to reach them.     

An Assessment of the Effectiveness of Two Tactics to Reduce Arousal in Crowded Mass Transit Settings1

Studies of crowding in various settings have shown that individuals are aroused and frequently suffer from ill health. Several studies have shown that it is possible to successfully intervene in residential, shopping, and classroom settings to reduce the negative effects of crowding. The present laboratory experiment assessed the effectiveness of two tactics commonly used by passengers in crowded mass transit settings. Results indicated that the two tactics, reading a newspaper or talking to others, failed to reduce arousal. An explanation for the failure of these tactics is offered.     

AN ECOBEHAVIORAL EXAMINATION OF A SIMPLE STRATEGY FOR INCREASING MEALTIME LANGUAGE IN RESIDENTIAL FACILITIES

Typically in large residential facilities for retarded persons, meals are served in an institutional style that does not appear to encourage appropriate peer interactions. An ecological program alternative is serving meals in a family style. The present study was designed to examine both the feasibility of serving family style meals and the effects of family style meal service on mealtime language. Five retarded young adult male residents, who had some conversational skills and appropriate table manners, participated in this study. The experimental design involved a multiple baseline analysis across meals (dinner, lunch, and breakfast). Observers coded the youths' mealtime verbalizations according to the type, content, and direction of the verbalizations and they recorded the length of the meals. The analysis of the verbalization data indicated that during family style meals the participants spoke substantially more often than during institutional style meals. Increases in peer-directed conversation about the meals primarily accounted for the verbalization changes. Family style serving also resulted in the youths spending more time with their meals. In addition, social validation measures suggested that the family style procedures were preferred by the consumers (participants, staff, and concerned community members).     

Performance of dyslexic children on speech perception tests

Several researchers who have compared the performance of dyslexic and normal-reading children on a variety of different tasks have suggested that dyslexic children may have subtle deficits in the phonemic analysis of spoken as well as written language. Thus it is of interest to know how children who have extraordinary difficulty learning to read can perform explicity auditory-phonetic tasks. Seventeen dyslexic children (10 years of age) and a group of 17 controls were administered tests of identification and discrimination of synthesized voiced stop consonants differing in place of articulation. These were tests of the type used to study categorical perception in adults, adapted for use with young children. Significant differences between dyslexics and controls were found in both kinds of tasks; the pattern of identification and discrimination differences suggests an inconsistency in the dyslexics' phonetic classification of auditory cues. A significant relationship was found between reading level and speech discrimination.     

Misperceptions of Motivation of Economically Disadvantaged Employees in Work Settings

The present study was designed to assess the cross-cultural perceptions of appropriate and inappropriate behaviors for three sets of role relationships. Employers and economically-disadvantaged job trainees were asked to rate the appropriateness of various behaviors for superordinate/subordinate, subordinate/superordinate, and peer/peer relationships. Results suggest that job trainees perceived the role of a superordinate as being more punitive, more deceitful, and less friendly than the employers thought would be appropriate. The findings are discussed in light of the concept of “ecosystem distrust”.     

Subjective contours can facilitate performance in a reaction-time task

Subjective contours were compared with objective contours in their ability to facilitate performance in speeded tasks that required judging the position of a dot or the slope of a line segment relative to the contour. Subjective contours were found to reduce both reaction times and error rates for dot localization but not for the more difficult slope discrimination task. These results add to the growing body of evidence suggesting that subjective contours have functional properties similar to those of objective contours.     

Causal attributions of high and low achievement motivation college students for performance on examinations

College students high and low in test anxiety attributed their performance on each of four examinations in a course to ability, test difficulty, preparation, and luck. Individuals high and low in test anxiety typically evidence systematic predispositions to account for their achievement-related behavior in different terms. The present research substantially replicated these earlier (laboratory and Intellectual Achievement Responsibility Scale) findings in an actual achievement setting. In addition, however, the present findings differed from the earlier evidence in some important respects. Specifically, (a) high test-anxiety students' attributions for failure were far less self-deprecating than in the laboratory evidence, and (b) high test-anxiety students' attributions (for both success and failure) became more personally flattering, or comforting, as the semester progressed. Results were discussed in terms of the laboratory — field distinction and of the influence of a temporal, or time of measurement, factor, hitherto ignored in the causal attribution literature.This research was facilitated by a grant from the Research Council of the Graduate School, University of Missouri-Columbia, and the National Institute of Mental Health (1 R08 31910), both to the first author.     

Stuttering and fluency: Exclusive events or points on a continuum?

In recent years, several studies have been conducted in which the fluency of stutterers was compared with that of normal speakers. These investigations have been of two basic types, some involving objective measures of physiologic, aerodynamic, or acoustic features of the subjects' fluent speech signal, and others involving experiments performed in which listeners attempted to distinguish the fluency produced by stutterers from that generated by normal speakers. The body of literature pertaining to each of these two types of investigations is reviewed and interpreted. The interpretations offered are then developed in an effort to shed further light on both fluency and stuttering. Implications for further research, as well as for the evaluation, treatment, and post-therapy assessment of stutterers are drawn.