On second-order family therapy

If family therapists remain aware of the indivisible and recursive nature of their interactions with families, and if they use this awareness to form a collaborative rather than a hierarchical therapeutic system, and at the same time minimize their attempts to change persons or family structures in strategic or predetermined ways, then they may be said to be practicing a "second-order" family therapy. This article analyzes the development of the second-order position on therapist power and influence, concluding that it is inconsistent and possibly disingenuous.     

Effectiveness of time-out: a comparison of psychiatric, correctional and day-treatment programs

The effectiveness of a time-out intervention for adolescent psychiatric patients, adjudicated (delinquent) youth, and behaviorally disordered youngsters was explored in this study. The research was conducted in three psychiatric hospitals for children and adolescents, a facility for adjudicated youth, and in a day-treatment program. Utilizing a comparative outcome model, 813 occurrences of time-out with 274 youth were investigated in order to assess levels of effectiveness. The results indicated that time-out had a significant impact, and the use of a child-care specialist as time-out monitor improves overall effectiveness. Important implications for practicing professionals and clinical researchers are noted.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

A comparison of alternative theoretical approaches to smoking cessation and relapse

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.