Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Perceived family environment as a moderator of young adolescents' life stress adjustment

A longitudinal design was employed to test the main and stress-moderating effects of young adolescents' perceived family environment (Family Environment Scales; FES; Moos & Moos, 1981) on their depression, anxiety, and self-esteem. This study was part of a larger longitudinal project (L. Cohen, Burt, & Bjorck, 1987) that demonstrated the significant cross-sectional effects of the young adolescents' controllable and uncontrollable negative events, and the significant longitudinal effects of the former. The present cross-sectional analyses demonstrated the hypothesized main effects of the FES scores; families perceived as cohesive, organized, and expressive were related to positive psychological functioning, whereas families perceived as conflict-ridden and controlling were related to negative functioning. However, in general these effects were nonsignificant in the longitudinal analyses. Although there were a number of significant Negative Events x FES interactions, in no instance did the pattern support the hypothesized stress-buffering role of positive family climate.     

Visual stimulation affects the perception of voluntary leg movements during walking

When a limb is used for locomotion, patterns of afferent and efferent activity related to its own motion are present as well as visual, vestibular, and other proprioceptive information about motion of the whole body. A study is reported in which it was asked whether visual stimulation present during whole-body motion can influence the perception of the leg movements propelling the body. Subjects were tested in conditions in which the stepping movements they made were identical but the amount of body displacement relative to inertial space and to the visual surround varied. These test conditions were created by getting the subjects to walk on a rotatable platform centered inside a large, independently rotatable, optokinetic drum. In each test condition, subjects, without looking at their legs, compared, against a standard condition in which the floor and drum were both stationary, their speed of body motion, their stride length and stepping rate, the direction of their steps, and the perceived force they exerted during stepping. When visual surround motion was incompatible with the motion normally associated with the stepping movements being made, changes in apparent body motion and in the awareness of the frequency, extent, and direction of the voluntary stepping movements resulted.