Altering student responses through changes in teacher verbal behavior

Two experiments were conducted in a junior-high special-education class of eight pupils in an inner-city school. In the first experiment, the teacher doubled the number of words used by the pupils in answering questions by altering the type of questions asked. In the second experiment, the number of words used by students and the percentage of answers given in complete sentences, increased from less than 5% to approximately 90% when the teacher instructed the pupils to answer in complete sentences and asked another pupil to answer using a sentence if the first one did not do so. In both experiments, a brief return to baseline conditions brought a return to low levels of verbal responding. An analysis of which pupils were called on by the teacher, teacher praise, and in the second experiment the types of questions asked, indicated that these variables were not responsible for the increases in verbal responding.     

The family check-up: a pilot study of a brief intervention to improve family functioning in adults

Many barriers exist for families seeking appropriate treatment for family problems. In an effort to minimize some of these barriers, we developed the Family Check-Up, a brief two-session family intervention. The Family Check-Up is based on the Drinker's Check-Up and consists of assessment, feedback, discussion, and goal setting. The purpose of the intervention is to help families identify and become motivated to make needed changes in any aspect of their family functioning. We conducted an open pilot trial of the Family Check-Up with 32 families. Our data suggest that the Family Check-Up (1) is sought out by the target audience, namely those with family problems; (2) is sought out by people with elevated depression symptoms or a history of treatment for depression or anxiety; (3) is feasible to conduct; (4) is acceptable to families; and (5) may be associated with changes in family functioning and depression symptoms over time. These results suggest that further research, particularly a randomized clinical trial, is warranted.     

Defining Location in the Mental Health System: A Case Study of a Consumer-Run Agency

In this ethnographic study of a mental health service agency staffed by “consumers,” or fellow “recipients” of services for serious mental illness, the concept of community narrative provides the framework for examining how such an agency preserves its consumer identity while providing services dictated by the established service system. Locating the agency's narrative in its “origins tale,” analysis revealed five principles comprising the agency's identity: a normalizing view of mental illness, a commitment to helping, a dual-valued understanding of the mental health system, and beliefs in recovery and in the significance of employment as a criterion for recovery. Predicted consequences of narrative functioning emerged in social climate and staff expressions of cohesion and commitment. The local meaning of these narrative themes reveals the agency's view of the consumer element in its work and its solution to the dilemma of being both inside and outside of the mental health system.     

Understanding Narratively,Understanding Alterity

Phenomenology's systematic exploration of how a world comes into existence for knowers – knowers who are often conceptualized as individual and ostensibly isolated – requires that it provide some account of the constitution of alterity. In this paper, I address this issue by arguing that we apperceive alterity in terms of the intentionality of behavior. A corollary of this argument is that the apperception of an alter as specifically human is a secondary attribution, following the primary apperception of intention. I further argue that the intentionality of behavior is understood through the projection of a narrative frame, or a “protonarrative,” onto the alter's behavior. I suggest that protonarrativity is the form that experience takes as its ontological condition. Our living is not simply known to us reflectively as protonarrative; rather, experience is lived as protonarrative.This essay is based on a paper presented at the annual conference of the Society for Phenomenology and the Human Sciences, Memphis, Tennessee, October 28–30, 2004.     

Health Care Reform: What History Doesn’t Teach

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform.     

Schizophrenia and the experience of intersubjectivity as threat

Many with schizophrenia find social interactions a profound and terrifying threat to their sense of self. To better understand this we draw upon dialogical models of the self that suggest that those with schizophrenia have difficulty sustaining dialogues among diverse aspects of self. Because interpersonal exchanges solicit and evoke movement among diverse aspects of self, many with schizophrenia may consequently find those exchanges overwhelming, resulting in despair, the sensation of fusion with another, and/or self-dissolution. In short, compromised dialogical capacities may be a contributing factor to social dysfunction in schizophrenia.     

Finding one's way home: Notes on the texture of moral experience

In this article, I seek to illuminate the texture of moral experience. I pursue that aim through a close reading of David Lean's film, Brief Encounter, produced in 1946. The chief protagonist in the film undergoes a moral odyssey that reveals and tests all that she has understood about how to conduct a life. Her experience sheds light on the constituents of an individual moral sensibility as well as how its enactment appears in practice when one confronts a heartfelt difficulty. I argue that moral experience is best understood through the idiom of narrative and character, rather than through ethical language that places formal or universal principle at the center of the moral life. In the workshop of the moral self, as Lean's protagonist reveals, the task is not to fashion or take on universal principles but rather to cultivate virtuous relations with other people in the here-and-now.     

Philip Roth'sPatrimony: Narrative and ethics in a case study

I assess the ethical content of Philip Roth's account of his father's final years with, and death from, a tumor. I apply this to criticisms of the nature and content of case reports in medicine. I also draw some implications about modernism, postmodernism and narrative understandings.A version of the first two sections of this paper was presented at the annual meeting of the Society for Health and Human Values November 6, 1993, Washington, D.C.     

Genetic counseling for the next 25 years: Models for the future

Currently, two trends pose particular challenges for genetic counseling: (1) spin offs from the Human Genome Project leading to new diagnostic genetic tests far in advance of any cures; and (2) an increasing and diversified client population. These trends will lead to changes in both genetic service delivery systems and the development of alternative models of the genetic counseling process itself. Two models that could be adapted for genetic counseling are: the mutual participation model and the life history narrative model. Technological advances present ethical dilemmas and raise many questions. Already, improved detection of genes for predisposing conditions has entered clinical medicine requiring renewed ethical appraisals of genetic testing. Integration of genetic counseling (and required pre-screening education) into primary care settings involves time constraints and the involvement of health care personnel with less training in genetics. Alternative approaches are beginning to be discussed. Innovative genetic counselors with expanded visions of counseling goals and practices will play an increasingly important role in the future of genetic counseling.