Improvisational therapy: Evolving one's own clinical style

This article offers an invitation to develop one's own unique clinical style, relying less on institutionalized schools of therapy and more on the therapist's own natural resources. An emphasis is placed upon understanding therapy as art, trusting one's imagination, and maintaining a healthy irreverence for professional politics.     

Subclmical depression and role fulfillment in domestic settings: Spurious relationships,imagined problems,or real effects?

Considerable evidence has accumulated in support of the hypothesis that subclinical depression may inhibit role performance in important ways. However, interpersonal stress and marital discord often precede the development of depressive symptomatology and may independently predict deficits in family role functioning. In addition, cognitive theories suggest that persons with subclinical depression may report poor role functioning even in the absence of any real performance deficits. The current research examines the possibility (1) that the effect of depression on the fulfillment of important family roles is attributable to previously unmeasured contextual variables of ongoing interpersonal stress and/or relationship dissatisfaction or, alternatively, (2) that this relationship is the result of depressive distortion associated with self-report of symptoms and performance. Multiple regression analyses of interview data collected from 495 community-dwelling adults found, however, that depression is related to role functioning beyond any spurious effects attributable to interpersonal stress, spousal stress, or marital satisfaction. In addition, the effect of depression persists when collateral reports of role functioning utilized. Accordingly, it appears that subclinical depression is related to decrements in role performance, and this effect is not entirely due to contextual elements or shared method variance between self-report measures.The authors acknowledge research support from Research Grants R01-AA-07250 and R01-AA-07218 from the National Institute on Alcohol Abuse and Alcoholism, Research Grant R01-DA-07417 from the National Institute on Drug Abuse, and National Institutes of Mental Health Grant A-41487-07.     

Distinguishing deviant and non-deviant nurses using the personnel reaction blank

Personnel Reaction Blank (PRB) scores and biographical data were obtained from two groups of registered nurses; a deviant group, represented by those who had official actions taken against their nursing license by the Minnesota Board of Nursing (n=53) and a non-deviant group of nurses (n=79) randomly selected from a broader population. The hypothesis that the deviant group of nurses would exhibit lower PRB scores, on average, compared to the non-deviant group was confirmed. The mean PRB scores for the deviant nurses (m=32.43) were significantly lower (p.01) than for the randomly selected non-deviant nurses (m=35.06). A multiple regression logit analysis showed that in addition to PRB scores, college degree, sex, and household income variables were also significantly related (p.001) to deviant and non-deviant group assignment; nonetheless, PRB significantly differentiated these groups after holding these variables constant.This study is based on the Masters thesis research of the first author. We acknowledge the help of the study subjects who contributed their time and effort.     

Family coping strategies and the rural Appalachian working poor

Naturalistic research methods were used in this study to collect the voices, ideas, and opinions of rural, working poor, Appalachian families from Southeast Ohio about the stress of poverty in family life and family coping in the face of poverty. This data should be of interest to the professional family therapist who practices with the working poor.     

Live supervision in the postmodern era of family therapy: Issues,reflections, and questions

This article asserts that the family therapy field is approaching an epistemological shift from structuralism and positivism to postmodernism and relativism. The confluence of these movements: feminism, constructivism/constructionism, and cultural relativism is cited as a major impetus for the shift. Live supervision is examined within the context of this transformation, with a discussion of implications for the future.     

Supervising the person of the therapist: Issues,challenges and dilemmas

A major critical issue in marriage and family therapy today is the professionalization of the discipline. Thus the focus on training individuals for a career in marriage and family therapy necessitates the revisitation of the debate over personal growth versus skill development. The trend toward training the person of the therapist, however, would suggest that the field is moving toward the integration of self awareness and skill in the therapeutic system. With the popularization of training the person of the therapist comes other issues, challenges, and dilemmas for the field, including the crucial issue of training gender and culturally sensitive therapists. The potential for creating dual relationships when training the person of the therapist is both a dilemma and a challenge.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

The mormon health traditions: An evolving view of modern medicine

The Mormon church has long been seen as an unusual group in relation to its health practices. But its health traditions and practices go much further than the ban on tobacco, coffee, and alcohol for which it is so well known. Church teachings and influences pervade the entire Mormon existence. This paper briefly discusses these traditions, first by examining their roots in the teachings of its first two prophet/presidents, Joseph Smith and Brigham Young. Then, how these ideas have evolved into the church's current thought is examined; and finally, the church's responses to many modern-day health care issues are presented.The author wishes to thank Dr. John King at Eastern Virginia Medical School in Norfolk, for his assistance and encouragement.