Distinguishing genetic from nongenetic medical tests: Some implications for antidiscrimination legislation

Genetic discrimination is becoming an increasingly important problem in the United States. Information acquired from genetic tests has been used by insurance companies to reject applications for insurance policies and to refuse payment for the treatment of illnesses. Numerous states and the United States Congress have passed or are considering passage of laws that would forbid such use of genetic information by health insurance companies. Here we argue that much of this legislation is severely flawed because of the difficulty in distinguishing genetic from nongenetic tests. In addition, barring the use by insurance companies of a genetic test but not a nongenetic test (conceivably for the same multifactorial disease) raises issues of fairness in health insurance. These arguments suggest that ultimately the problems arising from genetic discrimination cannot be solved by narrowly focused legislation but only by a modification of the entire health care system.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Training the supervisor: Integrating a family of origin approach

The replication of intergenerational patterns is considered here within the supervisor-family therapist-and family system, and the proposal of integrating a family of origin approach into the training of supervisors is presented. To become aware of the relation of one's own family of origin issues and their potential impact within the supervision and treatment can effectively improve intervention approaches, benefitting the supervisor, the therapist and the family in treatment. Being considerate of the training needs and levels of supervisors is an important component when integrating family of origin work into the training.     

“Operationalism” in psychotherapy: A possible means of putting a sorry state of theory in better order?

It will be shown in this paper that the study of the actual conduct of psychotherapy, at least in its classical form with a patient speaking his or her mind in any way the patient desires and a therapist helping the patient pursue those thoughts and wishes and conflicts and hopes for better luck in real life than before, is more conducive to agreement among rather different therapists, to clearer reasoning over psychotherapeutic interventions, and to more promising theoretical articulations than anything available in the theoretical texts of psychotherapy.     

The relation of family cohesion to marital adjustment

The purpose of this study was to investigate the relationship between family cohesion and marital adjustment. The sample consisted of 70 married graduate students from the State University of New York at Buffalo. The Family Adaptability and Cohesion Evaluation Scale was used to measure family cohesion. The Dyadic Adjustment Scale was used to measure marital adjustment. The Demographic Data Sheet was used for demographic characteristics. Overall, the result of ANOVA with planned comparison revealed that high marital adjustment was not only associated with a moderate level of family cohesion but also associated with a high level of family cohesion.This article is based on the first author's doctoral dissertation at State University of New York at Buffalo.     

Preference for modes of dispute resolution as a function of process and decision control

Research on procedural justice has suggested that the distribution of control among participants can be used to classify dispute-resolution procedures and may be an important determinant of preference for such procedures. This experiment demonstrates that control can be meaningfully divided into two components: control over the presentation of evidence and control over the final decision. The experiment placed subjects (law students and undergraduates) in a situation of conflict and varied two between-subjects factors: (1) Role, whether subjects expected to role-play third parties (law students) or litigants (undergraduates), and (2) Orientation, whether individuals focused on equity claims (appeals to a norm of fairness) or legal claims (appeals to a strict, legal interpretation of events). As a control, a third-party neutral-orientation condition was included. In addition, subjects were presented with four dispute-resolution procedures which varied in third-party control over the presentation of evidence (Process Control) and third-party control over the final decision (Decision Control) as within-subjects factors. Results revealed that both litigants and third parties preferred high rather than low third-party decision control. Litigants with an equity orientation preferred low third-party control over the presentation of evidence, particularly when third parties had high rather than low decision control. Third parties and litigants with a legal orientation preferred low rather than high third-party process control only when there was high third-party decision control. Litigant preferences were more affected by variation in process control than variation in decision control while third-party preferences were more affected by variation in decision control than in process control. As a check on external validity, military judges given a neutral orientation were asked to evaluate and express preferences for the four dispute-resolution procedures. Their results were not detectably different from those of the law students who role-played third parties in the main portion of the study.     

Goal attainment and satisfaction scores for CMHC clients

The purpose of this study was to explore the psychometric properties of goal attainment scales and client satisfaction measures. The findings revealed that goal attainment results, like other types of self-report psychotherapy outcome measures, are directly related to (a) indicators of a client's social class, and (b) the manner of treatment termination (unilateral dropout vs. mutual consent). The extent of client--therapist agreement on goal scores was relatively low thereby supporting the necessity of obtaining both perspectives in evaluating treatment outcome. Furthermore, because measures of client satisfaction were found to be sufficiently independent from goal outcome scores, it was concluded that they provide a unique source of program evaluation data. Finally, it was concluded that Goal Attainment Scaling is best considered to be a quality assurance tool for individual client/therapist dyads rather than a mechanism for the determination of the effectiveness of specific mental health programs and services.     

Anonymity reconsidered

This paper questions the concept of the therapist's anonymity and offers as an alternative the concept of an anonymity/self-disclosure dimension along which the therapist can position himself depending on several criteria. These criteria pertain both to characteristics of the therapist, the patient, and the material to be disclosed.     

Texture size specificity in the slant aftereffect

Transfer of the median plane slant aftereffect was assessed across changes in stimulus texture size (sine-wave grating frequency). Under binocular viewing, reliable decrements in aftereffect magnitude were observed when texture size was changed, compared with no-change control conditions. Under monocular viewing conditions, no significant aftereffects were found. The results indicate a spatial-frequency-specific component of binocular slant aftereffects.