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.     

Professional training of child psychologists

The present authors address the need for specialized professional training for psychologists who primarily work with the problems of childhood. It is argued that the area of child psychology is an amalgam of selected components of developmental, educational, and clinical psychology, and further that it is sufficiently discrete to warrant specialized training programs for child psychologists. Questions concerning the particular content of such training, and the level at which the training should take place, are raised. Various options regarding the answers to these questions are discussed, and a specific recommendation is presented.     

Visual short-term memory, response delay, and age

Recall and recognition memory performance of 12 young (M = 19 yr.) and 12 older (M = 72 yr.) females was studied in relation to response delay (5, 25, and 125 sec.) and stimulus complexity (6.1 and 13.7 bits of information). The subjects were matched on verbal IQ, visual acuity, and educational levels. Stimuli were abstract, black and white, 4 X 4 square matrices. Age-related decrements in memory performance were associated with stimulus complexity but not with response delay. Older subjects also reported experiencing encoding difficulties during the registration phase. The results were discussed with reference to the locus of age-related decrements in visual short-term memory.     

A rose is a rose is a rose: Minimalism in perception

The article by Wilcox and Edwards (1982) is discussed in terms of the notion of a Physics necessary for an explanatory theory of Perception. Phenomenological explanations, while true, are rejected as lacking explanatory adequacy. Some examples of succesful computational theories, covering the phenomena Gibson considered basic to an Ecological Physics, are given which are based upon a classical optics.     

Planning in the preschool years: The emergence of plans from general event knowledge

A framework for conceptualizing the relationship between event knowledge and planning is proposed, and two experiments are reported that examined children's ability to draw on event knowledge in planning. Preschool children were asked to plan and execute shopping trips to a pretend grocery store. Half of the children planned for two events on successive trials (Level 1, single-goal planning) and half of the children planned for two events simultaneously (Level 2, multiple-event planning). The amount of external support for planning was also manipulated. In Experiment 1, 3-, 4-, and 5-year-olds were presented with either a clustered or interleaved display. In Experiment 2, 3- and 4-year-olds were given adult assistance in plan construction. Results indicated that children's planning becomes more complex and flexible with age. Older children also rely less on external supports for planning. However, when external support was provided, 3- and 4-year-olds displayed higher-level planning abilities. Results are discussed in terms of the roles of event knowledge and external support in the early development of planning skills.     

Associative facilitation of word recognition as measured from a neutral prime

It is shown that lexical decision times to strong associates with an associative strength of approximately 40% are facilitated relative to targets following a neutral prime, “blank,” whereas very weak associates with an associative strength of less then 3% are neither facilitated nor inhibited. It is also shown that relative to the “blank” baseline time, a row of crosses inhibits processing of the following target. The latter finding has implications for earlier studies that have used crosses as a neutral prime. In these studies, facilitation effects have been overestimated and inhibition effects have been underestimated. Neely 1976 has proposed a predict-and-match strategy according to which subjects are assumed to predict one or more targets from the prime and to match the actual target onto the predicted targets. A part of this theory is not supported by the present data. The results are discussed in terms of the two-process theory of expectancy (Posner & Snyder, 1975). They are also considered in the light of a recent theory by Becker (1980). As an alternative interpretation of part of the reported data, a coherence assumption by the subjects about all reading materials is introduced.     

Factors affecting metamotivational reversals during motor task performance

Reversal theory proposes that the individual's psychological state constantly switches between metamotivational state pairs (such as Apter's 1982 telic-paratelic pair). Three factors are thought to affect reversals: frustration, contingent event, and satiation. Only a few studies have directly investigated these factors in sports contexts, and evidence is needed to assess support for these factors. In a laboratory setting, 24 participants performed a telic and a paratelic version of a dart-throwing task for 10 min. Participants were free to change from one task version to another as they wished, and reasons for any task changes were solicited. Task changes, indicative of reversals, were observed in 11 participants, and these were reported as due to satiation or frustration but not to contingent events. These findings may inform the structure of sessions on skill development but require confirmation in actual sports contexts.