The impact of the therapeutic environment

This paper emphasizes the impact of the setting, space, and general physical properties of the clinic upon the difficult patient's profound neediness and absence of inner regulatory structure. Moreover, the clinic's administrative style and requirements often related to fiscal restraints, demands for accountability for both how funds are spent and treatment outcome, all impinge upon the patient. Humanizing clinics so they have the capacity for psychotherapeutic holding and provision of safety for difficult patients are discussed in detail in this contribution.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.     

A record-keeping format for training systemic therapists

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.     

Systemic crisis intervention as a response to adolescent crises: an outcome study

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent-precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.     

Spatial coding in the processing of anaphor by good and poor readers: Evidence from eye movement analyses

An experiment that examined the way in which young readers deployed eye movements while reading sentences and while answering questions containing either a pronominal or noun anaphor is reported. To evaluate the possible causal role played by differences in inspection strategies between readers of above- and below-average reading skill, a third“age control” group of younger children was also tested. This group was matched on absolute reading ability with the less skilled group of older children, and on relative reading ability (i.e. reading quotient) with the more skilled group. Differences in inspection strategy were apparent between the groups of good and poor readers. Good readers launched more selective reinspections, whereas the poorer readers were more inclined to engage in“backtracking” and appeared to make less use of the displayed text. In every case there was a marked similarity in the behaviour of the good readers and the“age controls”. These results suggest that the ability to code the spatial location of words in a sentence, and, where necessary, to use this information to launch accurately targetted selective reinspections of previously read text, plays a crucial role in the development of skilled reading performance.     

The distorted room illusion, equivalent configurations, and the specificity of static optic arrays

The distorted room illusion (DRI) and the attendant argument for perceptual ambiguity is critically analyzed from a Gibsonian/ecological point of view. The notions of multiple specification, conflicting information, and perceptual skill are invoked in showing how the ecological approach can accommodate illusion effects that may remain under mobile binocular viewing conditions. Static optic arrays are shown not to be ambiguous. So-called equivalent configurations are found to be analytic artifacts, appearing when the problem of information is treated in geometrical terms without regard for constraints due to physical and ecological regularities. The relative importance of motion-based and motion-independent information is discussed.     

Developmental change in the understanding of affective meaning in music

The development of the understanding of affective meaning in music was investigated. Subjects aged 4, 5, 6, and 19 assigned verbal labels to musical segments previously determined by adults to be representative of one of four affects (happy, sad, angry, afraid). Analysis of correct interpretations and errors revealed a pattern of interactions among age, sex, and affect indicating that the ability to verbalize an understanding of affective meaning in music consistent with that of adult subjects is present during the preschool years. Age-related similarities in performance, as well as differences favoring both younger and older subjects, were observed and were discussed in relation to recent research in, and theories of, affective development and communication.The authors thank H. Julia Hannay, Edward Kemery, Shiela MacDonald, and Robert McGrath for their assistance in this research. The conceptual inspiration of Joseph Intrieri is gratefully acknowledged. We also thank Leslie Brody, Robin Hornik, and several anonymous reviewers for their comments on an earlier draft of the paper. Portions of this research were presented at the Southeastern Conference on Human Development, Baltimore, April 1982.     

The relationship among genital herpes simplex virus, stress, and social support

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.