Development of the Idiographic functional status assessment: A measure of the personal goals and goal attainment activities of people with AIDS

Abstract

This study presents the development of the Idiographic Functional Status Assessment (IFSA), an interview to assess functional status according to each person's unique point of view. This idiographic method asks people to state their personal goals in terms of things they want to accomplish, problems they want to solve, situations they hope to avoid, roles and relationships they want to maintain, and pursuits they want to relinquish. After describing their goals, respondents rate goal attainment activities they have pursued in the past month in terms of level of difficulty, dependence and other performance dimensions. In a study of 224 people with AIDS, the idiographic measure provided functional status scales that were relatively stable over time, and that correlated well with other subjective well-being measures and heath status criteria. Goal content measures derived from the interview can be used to distinguish sub samples that differ in terms of the determinants of quality of life.     

The role of additional information in the compliance,satisfaction, psychological,and emotion responses of non-surgical patients with low back pain: An exploratory investigation

Abstract

Noncompliance and the psychological and emotional states of patients with low back pain are major concerns for health professionals. The current study evaluated whether amount of information available to patients enhanced compliance to a medical regimen and whether it reduced negative emotions in patients with low back pain. Forty-five orthopaedic non-surgical patients with low back pain were randomly assigned to one of three information presentation conditions: 1) Standard, 2) Pre-examination, and 3) Post-examination. Patients were also separated by compensation and noncompensation within each information group. Patients completed questionnaires at their initial visit and at their follow-up which evaluated their: levels of compliance to a prescribed treatment program, psychological, and emotional states. Results indicated that some patients benefitted from receiving additional information as the Pre-examination and Post-examination groups demonstrated superior comprehension and recall as well as higher levels of compliance to a physical therapy program. In addition, compensation patients complained of more negative psychological and emotional behaviors in comparison to noncompensation patients. Implications of the research and future research considerations were discussed.     

Families with Physically Handicapped Children: Social Ecology and Family Systems

This paper reviews research on families with physically handicapped children, and integrates this work within a social ecological perspective. Methodological difficulties in past research that contribute to a lack of consensus in the area are discussed. Research on stresses experienced by various subsystems within families with handicapped children is presented, with recommendations for future family-oriented research and intervention. The interactions of families with handicapped children with their social support networks are reviewed, underscoring the importance of these processes for coping and adaptation.     

The Social Dynamics of Cigarette Smoking: A Family Systems Perspective

This paper uses family systems concepts and the Family FIRO model to show how cigarette smoking occurs in the context of the important relationships in a smoker's life. Specifically, smoking is viewed as a way a person is included in relationships, is in control in relationships, and perhaps is intimate in relationships. When smoking is well-established in the relationship, predictable interaction patterns surround it. When a person tries to quit or succeeds in quitting, these patterns change and may need to be replaced by nonsmoking alternatives. Partners may respond with support and willingness to create alternative patterns, or with undermining behavior stemming from a perceived threat to the established patterns. The model is offered for its heuristic value in guiding research and clinical experimentation. The paper also describes implications for family therapists as consultants to smoking-cessation programs.     

The Cybernetic Metaphor: A Critical Examination of Ecosystemic Epistemology as a Foundation of Family Therapy

This article proposes that recent disputes between two groups of family therapists, represented by Watzlawick and Keeney, have a substantive base as yet unexplicated in current literature. However, guiding principles of the approach known as ecosystemic epistemology have received considerable attention by Wittgenstein, a colleague of Russell's, and Rorty, a contemporary philosopher. Both contend that the prospect of systematizing language and culture may be ill advised. The article suggests that discussion regarding the nature and practice of family therapy ought not be confined to epistemological thinking.     

Circumplex Model VII: Validation Studies and FACES III

This paper reviews some of the recent empirical studies validating the Circumplex Model and describes the newly developed self-report measure, FACES III. Studies testing hypotheses derived from the Circumplex Model regarding the three dimensions of cohesion, change, and communication are reviewed. Case illustrations using FACES III and the Clinical Rating Scale are presented. These two assessment tools can be used for making a diagnosis of family functioning and for assessing changes over the course of treatment. This paper reflects the continuing attempt to develop further the Circumplex Model and to bridge more adequately research, theory, and practice.     

International Family Therapy: A View from Kyoto, Japan

"International family therapy" is an emergent field within (or overarching) the field of family therapy. At this stage, it can be described as the collecting and sharing of experiences by family therapists from different countries. Recent publications (7) gather information principally from Western cultures in which systemic family therapy has grown over the past thirty years. Japan is of particular interest to Western practitioners because it is a highly successful, post-industrial culture that differs markedly from the West. Familiar family therapy interventions often work for unfamiliar reasons, and different goals are often needed in order to respond to apparently similar family problems. An expanded sense of choice around strategies for family life and family therapy that such diversity implies is the primary contribution that this maturing, international family therapy movement can make to family therapy.     

Families and the Origins of Child Behavior Problems

This article reviews recent research into the relationship between family variables and child behavior. Although a diversity of factors may be associated with the development and maintenance of conduct/oppositional disorders in children, of primary importance are the moment-to-moment interactions that the child has with his or her primary caregivers. These are often marked by coercive, aggressive behaviors that may be functional for parents and children within the family system. However, the likelihood that parents will engage in coercive interactions with the child is also related to the latter's personal adjustment, which, in turn, is often dependent upon the parents' perceptions of the quality of marital and social support available to them. The goal for clinicians working with families of oppositional/conduct-disordered children is to retain the demonstrated efficacy of direct intervention into parent-child interactions while developing methods of assessment and treatment that attend to broader family variables, for example, marital disorder, interfering in-laws, and social isolation that may be functionally related to the occurrence of coercive parent-child interactions.