AN ALTERNATING TREATMENTS COMPARISON OF ORAL AND TOTAL COMMUNICATION TRAINING WITH MINIMALLY VERBAL RETARDED CHILDREN

This study was a comparison of the effects of oral speech with total communication (speech plus sign language) training on the ability of mentally retarded children to repeat 4-word sentences. Three children were chosen who used single words to communicate but who did not combine words into complete sentences. Three sentence pairs were trained, with each pair having one sentence trained using oral methods and an equivalent one trained using the total communication approach. Both training procedures involved chaining sentence parts, reinforcement, and prompting. Oral methods involved presenting vocal stimuli and requiring vocal responses whereas total communication methods involved presenting vocal and signed stimuli and requiring vocal and signed responses. For the initial sentence pair with each child, an alternating treatments design was used to determine the relative efficacy of the two language training approaches. This was repeated with a second and third sentence pair using a multiprobe technique within a multiple baseline design. Results pointed to the superiority of the total communication approach in facilitating sentence repetition. Possible explanations of these results are offered and the utility of the alternating treatments experimental design is discussed.     

Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, M_age = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.     

Effects of family therapy for substance abuse: A systematic review of recent research

One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.     

Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance

The process of engaging clients in homework assignments has been studied extensively in research settings, but rarely have the challenges in the implementation of the science been considered in couples and family therapy. A survey was conducted of 226 clinicians regarding (1) their experience of homework adherence (quantity and quality) with couple and family clients, and (2) their experience of the impact of homework non-completion (IHN) on the working alliance. Clinicians working with families reported less overall homework quantity and quality. However, across both couples and family clients, more negative IHN was reported among clinicians experiencing less homework quantity, both in terms of IHN bond (couple ρ = 0.71, p < 0.001; family ρ = 0.78, p < 0.001) and IHN agreement (couples ρ = 0.25, p < 0.001; ρ = 0.19, p = 0.006), and among clinicians with fewer years of clinical experience (r = 0.19, n = 136, p < 0.05). The present findings suggest that, in the context of couples and family therapy, there is a risk of perceived negative IHN on the working alliance. There would be merit to future investigations examining the processes of facilitating homework engagement within the context of a strong working alliance.     

Intensive specialised multi-family therapy for multi-stressed families: Therapeutic alliance as predictor for effectiveness

The effectiveness of intense specialised multi-family therapy (ISMFT) for 111 multi-stressed families, and the therapeutic alliance as a possible predictor of outcome, were examined. A repeated measures design was used, where changes in all ISMFT phases (preparation, multi-family therapy and follow-up) were assessed and compared for both mothers and fathers. Evidence was found for improved family functioning after the therapy period, which was maintained at 3 months follow-up, although the multi-stressed families still functioned in the problematic range. The therapy did however not decrease parenting stress, or did so only temporarily. Observations of the therapeutic alliance with the System for Observing Family Therapy Alliances (SOFTA) scales indicated that high therapist engagement was related to positive therapy outcomes, both at the start of therapy and later. High family engagement also predicted therapy effectiveness, but only at the start of therapy. The present study shows that solution-focused multi-family therapy at least seems to provide the first step in alleviating problems in multi-stressed families.     

Conceptualising,designing and drafting a monthly multi-family therapy programme and manual for adolescents with anorexia nervosa

The written transmission of therapists' expertise in manuals is an important issue which is highlighted in the literature. Manuals are essential for research, training and therapeutic guidance. However, the conceptualisation, design and drafting of therapy manuals have received little attention. Our team conceptualised and designed a 10-monthly session multi-family therapy programme for adolescents suffering from anorexia nervosa. This paper presents the methodology used to evolve from training and theoretical models to designing a programme and drafting the accompanying manual. We then describe how our team reached a consensus regarding the role to be attributed to food-related symptoms in the programme. These arduous tasks were rewarded by fruitful discussions among team members, which led to a shared theory of treatment. The methodology presented here is drawn from both the experience of specialised teams and from that of families in providing care to adolescents with anorexia nervosa.     

Further evaluation of prompt density,rate of reinforcement,and the persistence of manding

Previous research has evaluated the effects of prompt rates on the rate of communicative behavior. More recent research has suggested that dense prompting can result in communicative behavior that is more resistant to change. However, existing research has not considered the impact that higher response rates had on reinforcement rate, a variable known to impact response persistence. The current study systematically replicated previous research by evaluating communicative responding in contexts associated with dense- and lean-prompt schedules and extended existing research by (a) holding reinforcement rates similar across the two prompting schedules (lean and dense), and (b) evaluating the persistence of communicative responding in the contexts associated with each prompting schedule. The results for Experiment 1 clearly replicated and extended previous research. The results for Experiment 2 were equivocal and suggested that previous reinforcement history and response class size impacted outcomes.     

It's just (family) business: The impact of familial work experience on perceived qualification and hireability during the selection process

Though scholars have explored the impact of familial work experience (FWE) posthire, research has yet to determine the role of such experience during the selection process. Drawing from Attribution Theory and research on nepotism and family business dynamics, we suggest that the presence of FWE on an applicant's selection materials will lead to reduced perceptions of qualifications and hireability. Through two online experiments (N₁ = 170, N₂ = 251), we found mixed support for this proposition. In our first study focused on cover letters, we found that applicants who reported FWE were not appraised differently than those who did not. In our second study focused on letters of recommendation, however, we found that applicants who reported FWE were perceived as less qualified and less hireable. Moreover, we found that the level of job (i.e., service vs. managerial) moderates these relations, such that managerial applicants with FWE on their letter of recommendation were perceived as less hireable than those who did not. Implications for research and practice are discussed, and future research directions are offered.     

Affection deprivation is more aversive than excessive affection: A test of affection exchange theory

Affection exchange theory predicts that both excessive affection and affection deprivation are associated with poorer health, compared with receiving the level of affectionate communication that one desires. A similar yet-untested prediction is that affection deprivation is more aversive than excessive affection. This preregistered study tested both hypotheses on a battery of mental and physical health outcomes, including depression, loneliness, stress, physical pain, frequency of nightmares, and sleep quality, using a Census-matched sample of U.S. American adults (N = 827). As hypothesized, receiving the right amount of affection was associated with more health-supportive scores on all outcomes than either excessive or deficient affection. Similarly, excessive affection was associated with lower depression, loneliness, stress, and pain, and higher sleep quality, than affection deprivation.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.