Culturally Informed and Flexible Family-Based Treatment for Adolescents: A Tailored and Integrative Treatment for Hispanic Youth

The increasing utilization of evidence-based treatments has highlighted the need for treatment development efforts that can craft interventions that are effective with Hispanic substance abusing youth and their families. The list of evidence-based treatments is extremely limited in its inclusion of interventions that are explicitly responsive to the unique characteristics and treatment needs of young Hispanics and that have been rigorously tested with this population. Some treatments that have been tested with Hispanics do not articulate the manner in which cultural characteristics and therapy processes interact. Other treatments have emphasized the important role of culture but have not been tested rigorously. The value of well designed interventions built upon an appreciation for unique patient characteristics was highlighted by Beutler et al. (1996) when they argued that "psychotherapy is comprised of a set of complex tasks, and practitioners need comprehensive knowledge of how different processes used in psychotherapy interact with patient characteristics in order to make treatment decisions that will maximize and optimize therapeutic power" (p. 30). A focus on how treatment processes interact with patient characteristics is particularly relevant in the Hispanic population because of the considerable heterogeneity beneath the Hispanic umbrella. Our new program of clinical research focuses on articulating how the varied profiles with regard to immigration stressors, acculturation processes, values clashes, sense of belonging to the community, discrimination, and knowledge about issues important to adolescent health can be more effectively addressed by a culturally informed treatment.     

Fathers’ and Mothers’ Involvement with Their Adolescents

We explored mothers’ and fathers’ time spent with their adolescents and found that mothers reported spending more time with their adolescents than did fathers. Developmental patterns were found for some aspects of time involvement, with both mothers and fathers reporting higher involvement with younger adolescents. Ratings of time-spent were not associated with adolescents’ self-reported emotional/behavioral problems. Both mothers and fathers agreed that mothers had more responsibility for adolescents’ discipline, daily care, and recreational activities. Mothers and fathers reported comparable levels of satisfaction with this arrangement. Mothers, and to a lesser extent fathers, reported greater satisfaction with the division of labor when fathers showed higher levels of responsibility for adolescents’ activities. Satisfaction with the division of labor was inversely related to interparental conflict. Few differences were found based on adolescent gender for any of these variables. Results are discussed within the context of mother–child and father–child relationships and family functioning.     

《周易》家人卦的家道要旨

《周易》家人卦的家道理论体系,由立家之道、安家之道和兴家之道构成,且三位一体而又层层递进。立家之道,源于“阴阳变易”之化生原理,宏于“阴顺阳威”;付之践行,始于“闲邪未蒙”,功在“厉威勿纵”,誉于“顺德利贞”。安家之道,据于“允执厥中”的象位原理,适于“中正合宜”;履之于家,固于“持守正道”,毅于“谨遵中德”,成于各安角色。兴家之道,基于“民安国泰”的系统法则,旨在“家齐国治”;行之于家,寓于“王假有家”,系于交感互爱,遵于唯变所适。整个家道理论体系是一个系统有机统一的整体,极具系统性与辩证性。     

The Role of Family Functioning in Bipolar Disorder in Families

Investigated the association between family functioning and conflict and their links with mood disorder in parents and with children's risk for bipolar disorder. Participants were 272 families with a child between the ages of 5-17 years. Parents' history of psychiatric diagnoses and children's current diagnoses were obtained via semi-structured interviews. Parent report on the Family Assessment Device and the Conflict Behavior Questionnaire measured family functioning and conflict, respectively. Results revealed a small but significant indirect pathway from parental diagnosis of mood disorder to child bipolar disorder through impaired family functioning, via increased family conflict. Parental mood disorders were also significantly related to other negative outcomes in children, including unipolar depression and oppositional defiant disorder. Associations between parent diagnoses and family functioning changed depending on youth age, but not youth sex.     

Incorporating family therapy into asthma group intervention: a randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs.     

Testing the Biobehavioral Family Model in pediatric asthma: pathways of effect

This study uses a laboratory-based multiinformant, multimethod approach to test the hypothesis that a negative family emotional climate (NFEC) contributes to asthma disease severity by way of child depressive symptoms, and that parent-child relational insecurity mediates the effect. Children with asthma (n = 199; aged 7-17; 55% male) reported parental conflict, parent-child relational security, and depressive symptoms. Parent(s) reported demographics, asthma history, and symptoms. Asthma diagnosis was confirmed by clinical evaluation and pulmonary function tests, with disease severity rated by an asthma clinician according to NHLBI guidelines. Family interactions were evoked using the Family Process Assessment Protocol, and rated using the Iowa Family Interaction Rating Scales. Path analysis indicated a good fit of data to the hypothesized model (chi2[1] = .11, p =.74, NFI = .99, RMSEA = .00). Observed NFEC predicted child depression (beta = .19, p < .01), which predicted asthma disease severity beta = .23, p < .01). Relational security inversely predicted depressive symptoms (p = -.40, p < .001), and was not a mediator as predicted, but rather an independent contributor. The findings are consistent with the Biobehavioral Family Model, which suggests a psychobiologic influence of specific family relational processes on asthma disease severity by way of child depressive symptoms.     

The protégé's role in negative mentoring experiences

Negative experiences were obtained from mentors to identify the role played by protégés in creating difficulties within mentoring relationships. Content analysis revealed a wide range of examples, many of which were consistent with theory and research on dysfunctional mentoring and interpersonal relationships. The findings also indicated that the how typical the negative experience was related positively to its perceived impact on the relationship. Further, as the perceived impact of the experience increased, relationship satisfaction decreased. The results are discussed in terms of future research, mentoring theory, and applied practice.     

一个大学生的心理困惑——心理咨询案例

青少年心理健康教育是素质教育的重要组成部分,心理问题是阻碍青少年健康成长的重要因素之一。本文从帮助一个大学生摆脱心理痛苦的案例出发,介绍了心理咨询的一些方法、过程和技巧。特别强调了心理咨询要透过现象看本质,既要分析来访者所遭遇的负性事件,又要把握来访者的个性特征、成长经历以及父母教养方式等诸多因素。在治疗方面,既强调发挥来访者自我潜力的重要性,又要重视来访者家庭支持的辅助作用。     

Vocational aspirations of Chinese high school students and their parents' expectations

This study examined the vocational aspirations and parental vocational expectations of high school students and their parents (1067 parent–child dyads). Participants completed a demographic questionnaire and an Occupations List. The Occupations List consisted of 126 occupational titles evenly distributed across the six Holland types. Parents were asked to check the occupations that they expected their children to pursue and students were asked to select occupations to which they aspired. The expectations of parents were compared to the aspirations of children according to the occupational field, prestige, and sextype of occupations. The expectation–aspiration gap was relatively small for occupational field, but the gap was larger for occupational prestige and sextype. There were also gender differences for both expectations (parents' expectation toward sons and daughters) and aspirations (aspirations of male and female students). Types of high school (key or regular high schools) and parental educational background also related to expectations and aspirations. Theoretical, research, and practice implications are discussed.     

An Overview of Primary Care Family Psychology

This paper describes the application of family psychology to the primary care setting—in service, education and training, and scholarship. Primary care family psychology integrates family systems with biopsychosocial theory, yielding an approach that is uniquely suited to the generalist demands of primary care. This approach attends especially to the effects of relationships on health and healthcare, using the family as a potential resource to the patient just as the healthcare team is a resource to the clinician. Training opportunities in primary care family psychology are growing. The University of Rochester School of Medicine and Dentistry fellowship is described as an example, with core primary care family psychology training in four different clinical sites: Family Medicine, Internal Medicine, Pediatrics, and Obstetrics/Gynecology. Susan H. McDaniel is Professor of Psychiatry & Family Medicine, Director of Family Programs & the Wynne Center for Family Research in Psychiatry, and Associate Chair of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York. Dr McDaniel also directs the Primary Care Family Psychology Fellowship. Picter LeRoux is Associate Professor of Psychiatry & Pediatrics, and Director of the Family Therapy Training Program in Psychiatry, University of Rochester School Medicine and Dentistry, Rochester, New York. Dr. LeRoux also heads the Pediatric Track of the Primary Care Family Psychology Fellowship.