Fidelity Failures in Brief Strategic Family Therapy for Adolescent Drug Abuse: A Clinical Analysis

As evidence‐based family treatments for adolescent substance use and conduct problems gain traction, cutting edge research moves beyond randomized efficacy trials to address questions such as how these treatments work and how best to disseminate them to community settings. A key factor in effective dissemination is treatment fidelity, which refers to implementing an intervention in a manner consistent with an established manual. While most fidelity research is quantitative, this study offers a qualitative clinical analysis of fidelity failures in a large, multisite effectiveness trial of Brief Strategic Family Therapy (BSFT) for adolescent drug abuse, where BSFT developers trained community therapists to administer this intervention in their own agencies. Using case notes and video recordings of therapy sessions, an independent expert panel first rated 103 cases on quantitative fidelity scales grounded in the BSFT manual and the broader structural‐strategic framework that informs BSFT intervention. Because fidelity was generally low, the panel reviewed all cases qualitatively to identify emergent types or categories of fidelity failure. Ten categories of failures emerged, characterized by therapist omissions (e.g., failure to engage key family members, failure to think in threes) and commissions (e.g., off‐model, nonsystemic formulations/interventions). Of these, “failure to think in threes” appeared basic and particularly problematic, reflecting the central place of this idea in structural theory and therapy. Although subject to possible bias, our observations highlight likely stumbling blocks in exporting a complex family treatment like BSFT to community settings. These findings also underscore the importance of treatment fidelity in family therapy research.     

Treatment‐as‐Usual for Couples: Trajectories Before and After Beginning Couple Therapy

Couple therapy has been shown to be a meaningful way to improve couples’ relationships. However, less information is known about couples’ functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community‐based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted‐time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples’ relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples’ functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.     

The Quarter-life Time Period: An Age of Indulgence,Crisis or Both?

A new developmental stage called the quarter-life is proposed, extending from approximately 18–29 years of age and sometimes later. The emergence of this period is believed to be the result of several social, historic and economic factors that occurred post WWII. This article explores these changes in terms of the experiences of affluent young people in today’s Western society. A typology of adaptational responses are presented and explored as the quarter-lifers attempt to navigate their way to adulthood within the context of this ‘new’ affluent society. Implications for family therapists are considered.     

Alcohol Use in Adolescent Twins and Affiliation with Substance Using Peers

Affiliation with substance using peers is one of the strongest predictors of adolescent alcohol use. This association is typically interpreted causally: peers who drink incite their friends to drink. This association may be complicated by uncontrolled genetic and environmental confounds because teens with familial predispositions for adolescent substance use may be more likely to select into social networks where drinking is common. We test this alternative hypothesis using a sample of 1,820 twin and sibling pairs, and their same-sex best friends, from three waves of the National Longitudinal Study of Adolescent Health. Across all three waves, peer report of substance use did not influence adolescent alcohol use when genetic and shared environmental predispositions for drinking were considered. The association between alcohol use and peer behavior may be a spurious association attributable to a shared genetic liability to drink alcohol and associate with peers who drink alcohol.     

跨文化行为心理学——文化取向心理学第四方向

首先简要回顾比较了文化取向心理学的四个不同的方向：文化心理学、本土心理学、跨文化心理学,以及新的发展方向——跨文化行为心理学;重点介绍了跨文化行为心理学与文化碰撞情境概念的提出以及一个跨文化行为模型;其次提出了该学科在跨文化协同增效方面的重要应用;最后做出了在中国文化背景下开展相应研究的展望。     

Preschool Behavioral and Emotional Rating Scale (PreBERS): Test–Retest Reliability and Inter-Rater Reliability

The Preschool Behavioral and Emotional Rating Scale (PreBERS) is a standardized, norm-referenced instrument that assesses the emotional and behavioral strengths of preschool children. Two studies that investigated the test–retest and inter-rater reliability of the PreBERS are reported. In the first study, teachers rated preschool children (N = 96) on two occasions with 1 month between ratings. Reliability coefficients for the four subscales and total score of the PreBERS were all at or above 0.86. In the second study teachers and paraprofessionals rated the same preschool children (N = 88). All of the correlations were over 0.72. In both studies the magnitude of correlations were large indicating that the PreBERS is a stable measure across time and raters. Based on the data the PreBERS appears to be a psychometrically sound instrument appropriate for use with preschool children. Recommendations for use with preschool children as well as future research are discussed.     

The Opposite of Human Enhancement: Nanotechnology and the Blind Chicken Problem

Nanotechnologies that have been linked to the possibility of enhancing cognitive capabilities of human beings might also be deployed to reduce or eliminate such capabilities in non-human vertebrate animals. A surprisingly large literature on the ethics of such disenhancement has been developed in response to the suggestion that it would be an ethically defensible response to animal suffering both in medical experimentation and in industrial livestock production. However, review of this literature illustrates the difficulty of formulating a coherent ethical debate. Well structured arguments for disenhancement can be made on the basis of mainstream views on the basis of ethical obligations to animals, but these arguments have not been persuasive against the moral intuition that disenhancements are unethical. At the same time, attempts to ground these intuitions in a coherent philosophical doctrine have been plagued by logical fallacies and question begging assertions. As such, the debate over animal disenhancement forecasts an enduring conundrum with respect to the core question of transforming the nature of sentient beings, and this conundrum is logically independent of claims that relate either to the distinctive of human beings or to issues deriving from the emphasis on enhancement.     

Mediators of behavior change in two tailored physical activity interventions for adolescent girls

ObjectivesIt has been suggested that the lack of knowledge regarding the mechanisms responsible for behavior change may be responsible for the low levels of effectiveness in physical activity interventions among youth. While it is common for physical activity interventions to cite a theoretical framework, few test the validity of their constructs using an established mediation analysis technique. The purpose of this study was to identify mediators of physical activity behavior change in two tailored interventions for adolescent girls.DesignThis study involved an experimental design.MethodsParticipants (N=161) were randomly allocated to a control (CON) group, an intervention based on the Health Promotion (HP) Model or an intervention developed from the HP Model that included two processes from the Transtheoretical Model (THP). Both interventions included school-based education sessions, individual counseling sessions, and two physical activity sessions completed with the participants' mothers. Measures were assessed prior to the intervention, at post-intervention and at a 6-month follow-up. The following constructs were included in the mediation analyses: perceived benefits, perceived barriers, self-efficacy, exposure to models, social support, interpersonal norms, planning, stimulus control, and counterconditioning.ResultsPerceived benefits, perceived barriers, self-efficacy, and commitment to planning satisfied the criteria for mediation in the THP intervention. Self-efficacy and commitment to planning were identified as mediators in the HP intervention.ConclusionThe results of this study provide evidence that both interventions were successful in increasing physical activity through changes in the theoretical constructs.     

Perfectionism and Acceptance

The present paper argues that there is both a positive and a negative form of perfectionism, and that they can be differentiated in terms of acceptance. The basic argument is that there is nothing unhealthy or dysfunctional about the striving for perfection as such—perfectionism, however, becomes dysfunctional when this striving for perfection turns into a demand for perfection, defined as an inability to accept being less than perfect. Positive perfectionism, in other words, is viewed as a dialectic combination of (a) a striving for perfection, and (b) the acceptance of non-perfection. Some therapeutic implications are discussed, and some directions for further research are pointed out.     

多动症儿童的智力水平、行为与认知事件相关电位的研究

通过对多动症 (MBD)儿童的智力、行为和认知事件相关电位的分析研究,发现多动症儿童的智力水平正常但均数都低于正常儿童,行为问题的检出率和行为量表指数高于一般正常儿童,反映大脑认知功能的事件相关电位的N2、P3的潜伏期较之正常儿童组均延长,且差异均达到显著性水平。