Most family physicians report communicating the risks of adverse drug reactions in words (vs. numbers)

Family physicians can communicate to patients the risk of adverse drug reactions using words or numbers, and this format has important implications for patients' ability to make informed decisions. The present study (a) assessed which formats family physicians preferred to communicate the risk of a given side effect, (b) tested whether the severity of this adverse drug reaction affected this preference, and (c) investigated the type of quantifiers physicians preferred to use in general (e.g., ratios, percentages). In a format selection task, a sample of 131 family physicians reported that they mostly use words to communicate to patients the risk of mild and severe adverse drug reactions, but the verbal preference was weaker for severe adverse drug reactions. The quantifier selection task showed that the most common quantifiers were verbal frequencies and verbal probabilities. Family physicians and patients should be aware of the implications of this preference.     

Ancestral Voices, Spirits, and Magic: Dance a New Dance in the Family Therapy Room

Despite important moves toward reconciliation and dreams of a rainbow nation, the culture of violence impacts upon family and community life. This article is written within this context and more specifically within the writer's personal reflections on her practice of working as a family therapist in one of South Africa's largest black townships, Mdantsane. It challenges the relevance of first world theory and practice of family therapy in the third world context but is written in the first person and thus in the form of a reflective practitioner. The usefulness of the Milan approach is questioned and a move toward a social constructionist approach is favoured. The metaphor of dance and music is used to capture the dynamic interaction between client and therapist in the search for a relevant and respectful way of working with families in the South African context.     

Multigenerational stress and nuclear family functioning

This longitudinal study tested Bowen theorys assumption that stressors in the interdependent multigenerational family influence variation in nuclear family functioning. Forty-nine newly developing nuclear families and their multigenerational families were studied over five years. Quantitative analysis demonstrated an association between the perceived impact of multigenerational stressors and variation in nuclear family functioning. Multigenerational stressors, as compared to individual or nuclear family stressors, had a stronger association with nuclear family functioning. The stress response was manifested in symptomatic outcomes of the nuclear family emotional process. Generally, the number of stressors and the total impact of stressors increased over time, stressors in some years associated with functioning in subsequent years, nuclear family-of-origin stressors demonstrated a decreasing association over time, and developing nuclear family stressors demonstrated a somewhat increasing association over time.     

Controversies in counseling for mitochondrial conditions

A healthy woman sought preconceptional genetic counseling regarding a family history of a mitochondrial myopathy in her brother and retinitis pigmentosa (RP) in her two maternal aunts. Several questions were raised: (1) What is the likelihood of a familial mitochondrial condition? (2) What molecular tests or prenatal screening can we offer? (3) How would these tests help assess the likelihood of a familial mitochondrial condition? A mitochondrial mutation previously identified in the brother consisted of a heteroplasmic 2.9 kb deletion. We detected this deletion in the peripheral blood of the brother by PCR amplification of the deletion breakpoint, but not in his mother, the consultand, nor in one of the two aunts affected with RP. Although the molecular analysis was encouraging to the consultand, a familial mitochondrial disorder could not be eliminated with certainty. The pros and cons of prenatal testing for mitochondrial disorders are discussed in general, and as specifically related to this family.     

Relational diagnosis: An essay review

A review ofHandbook of relational diagnosis and dysfunctional family patterns. Florence W. Kaslow, Ed. 566 pages. $55. Cloth. ISBN # 0471-08078-0. New York: John Wiley & Sons, 1996.     

Of thorns and roses: The use of the “brier rose” fairy tale in therapy with families of gifted children

Fairy tales have been used successfully in addressing difficult therapeutic issues in indirect ways. This paper describes how the Grimm's tale Brier Rose can help engage families with an academically gifted child in family therapy. The metaphor concepts of derivational search, indirection, and embedded commands are briefly discussed, the fairy tale is summarized, and the story is applied to the three metaphor concepts.     

A Practical Account of Autonomy: Why Genetic Counseling is Especially Well Suited to the Facilitation of Informed Autonomous Decision Making

In genetic counseling, facilitation of autonomous decision-making is seen as a primary aim and respect for autonomy is used to justify a nondirective counseling approach whereby clients are free to make their own choices after being given all necessary information. However in the genetic counseling literature, autonomy as a concept appears to be interpreted variably and often narrowly. We offer a practical account of autonomy that is coherent, consistent and philosophically defensible for the genetic counseling setting. At the same time we demonstrate how nondirective counseling may serve to frustrate rather than facilitate client autonomy. We suggest that promoting purposeful dialogue rather than counseling that is nondirective is more conducive to client autonomy.     

Spirituality in MFT Training: Development of the Spiritual Issues in Supervision Scale

As spirituality moves increasingly to the forefront of the body of marriage and family therapy (MFT) literature, many clinicians still find it uncomfortable or difficult to address spirituality in therapy. This study presents a new measure—the Spiritual Issues in Supervision Scale (SISS)—that examines supervisees' perceptions of the degree to which spirituality is addressed in supervision. Researchers distributed the SISS to mental health professionals around the United States who either were receiving supervision currently or had received supervision recently from professionals in their fields or programs. Results indicated that the new instrument has evidence of reliability and validity.     

高三学生生涯未决的类型研究

生涯未决是生涯决策研究的一个重要问题。本文通过生涯决策困难和职业认同等测量工具调查了300名高中生,试图探讨生涯未决的类型。采用聚类分析,结果发现了5类未决类型:不知所措型、犹豫不决型、不良信念型、动机不足型、应对良好型。对总体决策困难和职业认同的差异检验证实了这五种类型。