Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.     

The holocaust of first nation people: Residual effects on parenting and treatment implications

The residential school experience was devastating for many First Nation (Indian) people. The lingering effects of this era have been far reaching and remain painfully evident throughout Native communities. One of the more obvious areas directly affected has been parenting. This paper discusses current parenting difficulties of Native clients who were formerly in residential schools. A connection is made between the abuse experienced by these individuals and their parental struggles. Along with addressing various sociopolitical issues, a number of clinical interventions designed to promote the healing process of these victims and their families are provided and discussed.     

Facilitator influence in facilitated communication

The use of facilitated communication with individuals with autism has generated considerable controversy over the past several years. Only recently has research begun appearing which examines the procedure using reasonable scientific controls to establish the validity of this form of communication. The present study assessed the validity of facilitated communication and evaluated the effects of facilitator influence with seven individuals with autism and mental retardation. Three individuals showed clear evidence of facilitator influence, another three showed no such influence, and one subject performed at chance levels. A follow-up session with the three subjects who showed no facilitator influence demonstrated that they also showed no unexpected language competence compared to their measured IQ and to assessment under standard conditions. Results are discussed in terms of significance for facilitated communication in general and in terms of the utility of the methodology as a means of demonstrating language competence or facilitator influence.     

Melodies in caregivers' speech: A species-specific guidance towards language

The author reports on a series of integrated studies on melodic contours in infant-directed (ID) speech. ID melodies in speech are taken as an instructive example of intuitive parenting in order to review current evidence on its forms, functions and determinants. The forms and functions of melodic prototypes are compared in terms of universal properties and individual and/or cultural variability across samples of German, Chinese and American mothers, and German mothers and fathers with their 2- and 3-month-old infants. Microanalyses of interactional contexts show that forms and functions of ID melodies are intimately related to typical dimensions of intuitive caregiving–arousing/soothing, turnyielding/turn-closing, approving/disapproving. The communicative functions of ID melodies as both categorical and graded signals are discussed with respect to the current knowledge on infant responses to ID speech and on early speech perception. According to a comprehensive longitudinal study of ID speech in relation to stages of infant vocalization, ID speech results from fine-tuned adjustments in various prosodic and linguistic features to developmental changes in infants' perceptual and vocal competence. ID melodies evidently have the potential to draw infant attention to caregivers' speech, to regulate arousal and affect in infants, to provide models for imitation, to guide infants in practising communicative subroutines and to mediate linguistic information. Current evidence suggests that the melodies in caregivers' speech provide a species-specific guidance towards language acquisition.     

Communication in preterm infants: Why is it different?

The present paper selectively reviews the literature which compares full-term and preterm infants' communication with their mothers in the first year of life. The review is focused not only on what differences are found between full-term and preterm infants, but also why such differences exist. Particular emphasis is placed on the importance of interpreting the findings in the light of the developmental phase of the infants, the heterogeneity of the preterm population and the situation in which communication is studied. Most studies were not designed to consider these issues in any detail. Differences with respect to these factors can be found between studies, however, which may have contributed to the often contradictory findings. Consequently, comparisons between these studies provide clues about the effects of these factors on communicative development. The ultimate goal of this review is to point to important directions for future research on early communication in preterm infants.     

Internet resources in applied behavior analysis

Internet communication is becoming an important tool for both academic and clinical areas in psychology and behavior analysis. The Internet, a confederation of thousands of computer systems covering the entire globe (Plaud, 1996b), can significantly enhance behavior analysis in at least three major areas: (a) information exchange and communication among behavior analysts through list servers, (b) dissemination of empirical data and commentary through on-line journals and information servers, and (c) promotion of programs and services in behavior analysis. This commentary provides specific examples in each of these areas and addresses the basics of connecting to the Internet.     

CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Culturally Sensitive AIDS Educational Videos for African American Audiences: Effects of Source, Message, Receiver, and Context

The importance of using culturally sensitive educational materials in HIV-related interventions with racial and ethnic minority groups is widely recognized. However, little empirical research has been conducted to assess the relative effectiveness of different techniques for creating culturally sensitive AIDS educational videos. Two field experiments with three samples of African American adults (N = 174, 173, and 143) were conducted to assess how source characteristics (race of communicator), message characteristics (multicultural message vs. culturally specific message), and audience characteristics (racial distrust and AIDS-related distrust) influence proximate (perceptions of the message's credibility and attractiveness) and distal (AIDS-related attitudes, beliefs, and behavioral intentions) output variables for AIDS educational videos. In Study 1, an AIDS video with a culturally specific message was rated as more credible, more attractive, and of higher quality than was a video with a multicultural message. The multicultural message was rated less favorably when delivered by a White announcer than when the announcer was Black. In Study 2, the same pattern was replicated with a second community sample and a campus-based sample. Study 2 also indicated that a multicultural message might be more effective if delivered in a culturally specific context, namely, after audience members watch a culturally specific video. Minimal changes were observed in distal outcome variables. It is argued that influencing proximate output variables is necessary, though not sufficient, for effecting long-term change in AIDS-related attitudes, beliefs, and behaviors.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.