Family system functioning: behavior in the laboratory and the family treatment setting

The Family System Functioning (FSF) scale is a new instrument for measuring dimensions of the intrafamilial environment thought to be important in recovery from major psychiatric illness. Modest statistical correlations were obtained when FSF ratings of laboratory-based family interactions were compared with researcher-guided therapist ratings of FSF based upon the family's behavior in family therapy sessions during the subsequent month. The data from these two settings provide support for the validity of some of the scales. Because of the modest size of the correlations, however, behavior in the laboratory setting may not always be an accurate indicator of how the family will behave in the early weeks of family therapy.     

Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

An indigenous community mental health service on the Tohono O'odham (Papago) Indian reservation: Seventeen years later

The status of a fully indigenous mental health program serviced and controlled by the Tohono O'odham (Papago) Indian tribe is reviewed from the perspective of its 17-year history. The program functions in large measure in a crisis intervention model, with suicidal or acutely disturbed cases being most frequent. However, a whole range of disorders and ages are seen. Traditional Medicine Men and Women are often used as consultants, as are some professionals. In recent years child sex abuse and abuse of drugs among youth are prominent problems. The program experienced problems of obtaining services off reservations for patients in need, and in establishing credibility of the Indian Mental Health workers with the outside service providers.     

A reanalysis of the influence of a "friendly visitor" program

A paper in the American Journal of Community Psychology (AJCP), by Reinke, Holmes, and myself, reported the results of a study of the influence of a friendly visitor program on the cognitive functioning and morale of elderly individuals. The program was reported to have had a significant multivariate effect on a combination of cognitive and morale measures and significant univariate effects on memory, self-perceived health, and activity director's ratings. Being intrigued by the memory finding, I conducted a follow-up study to further investigate the effect of a visitation program on cognitive functioning. In this second study the dependent measures included all of the cognitive variables included in the original study as well as some additional memory variables. The visitation program in the follow-up study had no effect on any of these measures. As a result of my failure to obtain a significant memory effect such as that reported in Reinke et al. (1981), I reanalyzed the data from the original study. In my reanalysis, the only significant effect was a borderline univariate effect for self-perceived health; the multivariate effect did not approach significance. On the basis of my inability to produce the results reported in Reinke et al. when I reanalyzed the original data, I must conclude that the friendly visitor program did not have the effects attributed to it in the original report.