Termination of Mental Health Services for Children

In this paper, we examine the termination of children's mental health services. Analyses were based on the 901 families in the Fort Bragg Evaluation Project who participated at Wave 1 and Wave 2 six months later. The project compared a full continuum of care provided at a demonstration site with traditional care at two comparison sites. The results showed that in most cases families and providers were partners in decisions to terminate treatment. About half of the clients self-terminated or were terminated solely at the discretion of the provider. Providers tended to play a more dominant role in terminating restrictive services; families played a more central role in terminating outpatient care. Regardless of initial psychopathology, children in single-headed households, whose parents were dissatisfied with services, did not expect their child to cooperate with treatment and did not expect treatment to help their child, were more likely to terminate care than others. While the Demonstration site had significantly fewer terminations, the sites did not differ with regard to the reasons for termination, who participated in termination decisions, or the factors that affected the likelihood to terminate care. Of most interest, mental health outcomes among children who had terminated all care did not vary by reasons for termination or by who participated in the termination decision.     

Separability of item and person parameters in response time models

This paper discusses two forms of separability of item and person parameters in the context of response time (RT) models. The first is separate sufficiency: the existence of sufficient statistics for the item (person) parameters that do not depend on the person (item) parameters. The second is ranking independence: the likelihood of the item (person) ranking with respect to RTs does not depend on the person (item) parameters. For each form a theorem stating sufficient conditions, is proved. The two forms of separability are shown to include several (special cases of) models from psychometric and biometric literature. Ranking independence imposes no restrictions on the general distribution form, but on its parametrization. An estimation procedure based upon ranks and pseudolikelihood theory is discussed, as well as the relation of ranking independence to the concept of double monotonicity.I am indebted to Wim van der Linden for bringing Thissen's (1983) paper to my notice, and to Martijn Berger, Frans Tan, and the anonymous reviewers for their constructive comments on earlier drafts of this paper.     

Family Secrets: The Case of the Patient Kept in the Dark

The author examines the position of a child from whom important matters in his or her own life or key events in the family have been kept secret, outlines criteria by which the decision whether or not to unveil the secret should be made, and urges colleagues to gather more data and examine further family secrets.     

Immigrant Stepfamilies

Immigration and remarriage are two stressful events that impact on family's functioning and well being. This article examines the effects on families of experiencing both of these transitions simultaneously. A case illustration is presented and implications for practice and for future research are discussed. The article is based on the clinical experience of the writer as well as on her study of stepfamilies from diverse cultural backgrounds.     

Textbooks in Accredited Marriage and Family Therapy Programs

Although choices of required textbooks are important decisions in developing a course curriculum, faculty in marriage and family therapy training programs have few convenient resources to guide curriculum development. This article presents results of a survey of textbook selections of accredited marriage and family therapy programs within a regional affiliate of AAMFT. The five programs surveyed listed 108 different titles used in their curriculum. Only 12 texts were used by two programs, and only one text was used by more than two programs. This article presents the textbook selections by the six curricular areas of COAMFTE accreditation standards. The wide variety of textbooks used by programs leads us to conclude that no consensus exists about what textbooks best represent the core knowledge of marriage and family therapy. The body of knowledge taught in accredited marriage and family training programs reflects a distinct and autonomous body of knowledge.     

Themes in Therapist Development During the First Three Months of Clinical Experience

The results of a qualitative research study designed to better understand the developmental processes active in beginning therapists during the first three months of clinical contact is reported. Thirteen beginning therapists were asked to complete a monthly log describing experiences impacting their clinical work and themselves as therapists during their first three months of client contact. Data analysis revealed that the primary developmental theme active during this period of time is the development of therapist confidence. Two additional themes, the development of an internal gauge on which to evaluate current experiences and the development of boundaries around the self as a professional, were also found to be active during this time. These additional themes support the development of therapist confidence. Implications for training and research are identified.     

Child abuse and neglect by parents with disabilities: A tale of two families

Two families, in which the children had been placed in foster care due to abuse and neglect by parents who had disabilities, were studied. In the first case, the mother was instructed in skills that our assessment suggested were important for her child's survival. The mother readily acquired and applied these skills, a fact reflected both in changes in her behavior and in changes in the child's well-being. In the second case, the parent's incremental resumption of child custody was made contingent upon completion of relevant parenting tasks. Initially, improvements in the completion of such tasks were evident, but over time and with the onset of militating factors, no further progress was made and all parental rights were terminated. The implications of these cases for behavior analysis and the effort to reunite and preserve families are discussed.     

Occupational conditions and workers' sense of community: Variations by gender and race

The literature is reviewed to define a sense of community in the workplace and to identify factors that may foster it. A model is developed and estimated with survey data from a culturally diverse sample of men and women performing lower-level jobs at a medium-sized manufacturing firm. Results of regression analyses are reported that correct for sample selection bias resulting from the lower response rates of minority workers. Findings suggest that well-designed jobs and supportive workplace relationships and policies are important in explaining workers' sense of community, defined as workers' perceptions of mutual commitment between employee and employer. Informal sources of support play a larger role in explaining men's sense of community, while formal sources of support are more important in explaining women's sense of community. Findings further suggest that African American workers, especially women, have a difficult time experiencing a sense of community at work. The authors thank the employees of Fel-Pro for their participation in this study and Melissa Roderick, Michael Sosin, and anonymous reviewers for their thoughtful comments. This research was funded by the Fel-Pro/Mecklenberger Foundation and the Lois and Samuel Silberman Fund.     

Parallel short forms of the family of origin scale: Evidence of their reliability and validity

Two parallel short forms of the Family of Origin Scale were developed from data provided by 69 women and 63 men who completed the full Family of Origin Scale along with a variety of measures of family-of-origin characteristics. Data on the reliability and validity of the short forms are provided and discussed. The results indicate that both short forms are strongly and significantly correlated with each other and with the full-scale version of the FOS and that they share its reliability and validity characteristics to a very high degree.