Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

SPEECH PERCEPTION AS A TALKER-CONTINGENT PROCESS

Abstract— To determine how familiarity with a talker's voice affects perception of spoken words, we trained two groups of subjects to recognize a set of voices over a 9-day period One group then identified novel words produced by the same set of talkers at four signal-to-noise ratios Control subjects identified the same words produced by a different set of talkers The results showed that the ability to identify a talker's voice improved intelligibility of novel words produced by that talker The results suggest that speech perception may involve talker-contingent processes whereby perceptual learning of aspects of the vocal source facilitates the subsequent phonetic analysis of the acoustic signal     

Coping with peer stressors and associated dysphoria: Acculturation differences among Chinese-American children

The purpose of this study was to explore the role of acculturation in coping with stress among 264 Chinese-American children. The results confirmed that the subjects used a variety of coping strategies including diversion, suppression, problem solving, minimization, and retaliation and that certain coping strategies influenced the dysphoria experienced as a result of peer stress. High acculturated children used retaliation significantly more often than their low acculturated counterparts and retaliation was found to be associated with less dysphoria for the high acculturated group. In contrast, low acculturated children who utilized suppression tended to report less dysphoria. Contrary to the hypothesis that general self worth would reduce the relationship between peer stressors and dysphoria, it had no bearing on the association for either acculturated group. The hypothesis that greater perceived social competence would lessen the association between peer stressors and dysphoria also failed to be supported by the data. In fact, for the high acculturation group higher social competence was actually associated with more reported dysphoria. In general, the results suggested that the adaptiveness of particular coping strategies may be influenced by acculturation level and that social competence plays a complicated role in the stress and coping process. Implications for counsellors are discussed.     

Counselling foreign students: A review of strategies

This article focuses on the unique counselling needs of foreign students as reflected from a review of the literature. As more and more students from developing countries opt to further their education in the West, knowledge about counselling foreign students is of increasing interest. Distinctive aspects of foreign student clients and the typical problems faced by them are described. The issues which need to be addressed and the competencies which need to be developed in order to effectively counsel foreign students are discussed. Finally, specific strategies for counselling foreign students are suggested in the context of general guidelines for cross-cultural counselling.     

Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.     

The patient-physician relationship and the allocation of scarce resources: a law and economics approach

Patients with insufficient financial resources place physicians in a conflict of interest between the patients' needs and the financial interests of the physician, other patients, and society. Not only must physicians act ethically, but they must avoid liability for violating their legal duties to their patients. The traditional rules of contract and malpractice law that govern the patient-physician relationship do not provide satisfactory guidelines. Better answers are found in the rules of fiduciary law, but only with regard to direct conflicts between patients and physicians and only at the risk of reducing patient access to care. Certain types of legislative action can resolve these conflicts by altering the traditional legal rules, but care must be taken to preserve patient-physician trust, which the legal rules were designed to enhance.     

Success,social comparison,and self-assessment: Parents' midlife evaluations of sons,daughters, and self

The literatures on sex-role socialization and social comparison theory were used to predict how parents would evaluate the life success of adult sons and daughters and how parents' assessments of themselves would be influenced by comparisons with these children. Although parents (N=215) did not report different levels of life success for 291 adult sons versus 251 adult daughters, parental well-being was more closely tied to assessments of sons' success. In addition, although parents' reported that both sons and daughters had exceeded their own life success, theparent-child comparison with daughters was the better predictor of parents' well-being. Findings are discussed in terms of parents' individual development, family processes at midlife, and cohort differences between parents and their children.     

Bearing bad news: Dealing with the mimics of denial

Denial is a common label for certain reactions to bad news. However, true denial is rare, and most cases actually represent a variety of responses with very different causes and needs. Three of these, disbelief, deferral, and dismissal, are characterized according to origins and needs. Failure to differentiate between these seemingly similar behaviors can result in inappropriate counseling, and interfere with attempts to convey information and provide support during a time of crisis.