The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care.     

Solving the rod-and-frame test in a tachistoscopic presentation: Effects of stimulus size and perceptual style

This research was undertaken to demonstrate, with correlational evidence, that presenting the rod-and-frame test (RIT) with either limited (tachistoscopic) or unlimited (Oltman’s, 1968, portable RFT) exposure time does not significantly affect the ranking of subjects. The underlying hypothesis is that the intersubject variability of performance on the portable RFT is due essentially to differences in sensitivity to the optostatic vection that appears automatically and almost immediately. Results of the tachistoscopic test show that the effect of angular size of the stimulus is similar to that described in the literature for unlimited time situations, and that subjects’ ranking is very similar regardless of the exposure time (W = .80). However, although a difference is observed between the means of low and high achievers in both types of RFT, intraindividual intertask homogeneity (correlation coefficient) is not verified in each of these subgroups. From these results, one can distinguish two processes in the RFT: the first, vections, has to do with the subject’s postural orientation and seems to playa great role in organizing interindividual differences. The second process, a more cognitive one, has a less striking effect and has to do with the selection of reference frames in perceptual organization.     

Electromagnetic articulography: use of alternating magnetic fields for tracking movements of multiple points inside and outside the vocal tract

The purpose of this paper is to present a new electromagnetic device which uses alternating magnetic fields for tracking movements of multiple points inside and outside the vocal tract. It is biologically safe, noninvasive, it does not interfere with speech movements, allows for multiple recording in the same subject, and for easy collection of large amounts of data. It is especially suitable for evaluation of patients with speech motor impairments.