The (HI)Stories We Live by: Power/Knowledge and Family Therapy in Africa

There is a need to Africanise family therapy so as to serve the interest of local communities. Western approaches to family therapy have been accused of being irrelevant to African contexts. They are seen as forming part of a dominant scientific knowledge which invalidates local folk and cultural psychologies and thereby continuing a historical tradition of oppressive colonial power relations. This paper aims at archaeologising and evaluating such criticism by situating family therapy within different fields of knowledge that have emerged historically and are currently co-existing in Africa. The advantages and disadvantages of dominant family therapy approaches in African contexts are explored by focussing on power relations between different knowledges in Africa. It is argued that many global narratives of family therapy offer congenial companionship to many local African narratives, but that family therapists should pay more attention to local spiritual and political narratives so as to attain more legitimacy and validation by local communities.     

Update and Review: Cystic Fibrosis

Cystic fibrosis (CF) is one of the most commonly inherited recessive disorders in U.S. Caucasians, with a carrier frequency of approximately 1 in 29. Genetic counseling and CF mutation analysis has traditionally been offered to the affected patient and his/her extended family, in keeping with policy statements from professional organizations (ASHG, NSGC, ACOG). The target population for CF testing and counseling may be evolving after the release of the 1997 National Institutes of Health Consensus Statement, Genetic Testing for Cystic Fibrosis, which recommends that CF screening be offered to all preconceptional and pregnant couples. Genetic counseling for CF is complicated by reports of polymorphisms in the CF gene that are associated with symptoms that do not meet the diagnostic criteria for CF, such as bilateral congenital absence of the vas deferens, bronchiectasis, and idiopathic pancreatitis. To aid genetic counselors with these issues, this review explores the symptoms of CF, patient management, gene function, genetics, genotype/phenotype correlation, and genetic counseling issues.     

Reviews

Michel Serres Genesis
John Earman Bangs, Crunches, Whimpers, and Shrieks: Singularities and Acausalities in Relativistic Spacetimes
D. Bohm and B. J. Hiley The Undivided Universe: An Ontological Interpretation of Quantum Theory     

The Spiritual Task of Religion in Culture: An Evolutionary Perspective

It is quite impossible to consider human nature within an evolutionary perspective if we leapfrog over culture and establish some direct relation between cosmic and human evolution without taking culture into consideration. Culture holds a significant place within the structures of nature, as the "epic" of evolution portrays nature—cosmic, physical, and biological. Religion emerges within culture, and it plays a role in organizing the human consciousness and in generating the stories, rituals, and morality that constitute the organization of consciousness. Since organization of consciousness determines how culture is conducted, and since we face a global crisis today because of the ways we are conducting our culture, religion's role is critical for the future of culture. Wherever it is attempted, whether in terms of traditional or posttraditional modes, the fashioning of adequate worldviews, rituals, and morality is an essentially religious activity. For both traditional and posttraditional modes, the task is to weave structures of meaning with the sciences of evolution so as to effect the most suitable organization of consciousness.     

What Every Teacher of Science and Religion Needs to Know about Pedagogy

This essay provides practical tips for effective teaching in science-and-religion courses. It offers suggestions for dealing with difficult questions and creating a climate of shared learning. Along with pedagogical advice, it covers fundamental principles for teaching broadly integrative religion-and-science courses. Instructors are encouraged to reflect on their purpose(s) in offering their course and to formulate specific objectives using the techniques and resources outlined here.     

Religion and Science in America: Struggling for Coherence

James Gilbert has provided fascinating and valuable historical sketches of the interactions of science and religion in American culture in this century, especially those taking place between 1945 and 1962. Yet, taken together, it is unclear what conclusion is to be drawn from these interactions. Ambiguity about the variety of forms of the science-and-religion relationship and about the referent of the term religion make the task of apprehending a coherent pattern among these sketches very difficult.     

Tales from the Crypt: On the Role of Death in Life

An existential psychodynamic theory is presented based on Ernest Becker's claim that self-esteem and cultural worldviews function to ameliorate the anxiety associated with the uniquely human awareness of vulnerability and mortality. Psychological equanimity is hypothesized to require (1) a shared set of beliefs about reality that imbues the universe with stability, meaning, and permanence; (2) standards by which individuals can judge themselves to be of value; and (3) promises of safety and the transcendence of death to those who meet the standards of value. An empirical research program in support of this theory is then described, and the personal and interpersonal implications of these ideas are briefly considered.     

Life Circumstances and Personal Resources as Predictors of the Ten-Year Course of Depression

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.     

The Program Environment Scale: Assessing Client Perceptions of Community-Based Programs for the Severely Mentally Ill

The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their quality of life in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different aspects of programs as clients perceive them. In the programs we visited, directors felt the PES covers the important things they want to know about how clients perceive their program. The PES should become a useful tool both for researchers interested in how client responses to programs may influence their therapeutic outcomes, and for practitioners interested in improving their clients' program experiences and/or increasing convergence of staff and client views of their program.