The EPPI family therapy outcome study

Information was evaluated from 1014 families seen in an eight-year period by therapists connected with the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia. Statistical analysis revealed several factors that had some predictive value in relation to outcome of therapy; these were race, past psychiatric hospitalization, type of presenting family problem, and number of sessions held. There was a rather good chance of improvement being noted by the therapist if the family stayed in treatment for eight or more sessions. About 90% of the cases were seen for less than 20 interviews. Only about 3% were seen for longer than 35 interviews. The vast majority of EPPI cases were short-term. Black families tended to present different problems from white, and therapy was terminated with blacks sooner than for whites. About 35% of families terminated after one to two interviews, and another 30% after three to seven sessions. Since families tended to benefit most after eight or more sessions, the need for better methods or techniques to engage families is highlighted.The research was supported in part by a Career Development Award from the University of California, San Francisco, to the first author.     

Engagement and recruitment for family therapy research in community settings

Based on the recruitment experience in a family therapy research project with heroin addicts, this paper explores the difficulties of researcher networking with other social service agencies. Concepts from contextual family therapy are used to explore four general areas that contribute to successful intra-agency relationships: 1) Evaluating the nature of larger system relationships; 2) identifying the resources and needs of a clinic; 3) joining with the counseling staff; and 4) addressing the impact of public policy and ideology on clinic life. A case of engaging one clinic is presented and nine guidelines for engaging large community settings for participation in family therapy research are offered. These areas are considered in light of the relational dynamics that arise when working with multiple social service systems.An earlier version of this paper was presented at the American Family Therapy Association conference in Washington, DC, June 1986. The authors are grateful to the recruitment staff of the Intergenerational Family Therapy Project: Guillermo Lopez, Bart Rubin, Sharara Godfry, and Armando Chenyek. This research was supported in part by a grant to Guillermo Bernal from the National Institute on Drug Abuse (DA03543).     

Intervention development and cultural adaptation research with diverse families

This article provides an introduction to the special issue on intervention development and cultural adaptation research with diverse families. The need for research on intervention development and on cultural adaptation of interventions is presented, followed by a discussion of frameworks on treatment development. Seven articles included in this special issue serve as examples of the stages of treatment and intervention development, and of the procedures employed in the cultural adaptation with diverse families. An overview of the seven articles is provided to illustrate the treatment development process and the use of pluralistic research methods. We conclude with a call to the field for creative and innovative intervention development research with diverse families to contribute to the body of evidence-based practice with these populations.     

Hysterectomy and autonomy

Hysterectomy (or hysterectomy with oophorectomy) is the most frequently performed major surgery in the United States, affecting approximately 700,000 women each year (Easterday, 1983). There has long been interest in the psychological effects of these surgeries. However, apart from the concern that some hysterectomies may be unnecessary (Pearse, 1976), there has been little attention to bioethical issues relating to hysterectomy. Physicians and nurses are ethically obligated to respect the woman who may have a hysterectomy by treating her as an autonomous agent. Informed consent within the context of a decision for hysterectomy should include balanced information and supportive exploration of the woman's values, goals, and life plan. Care of the patient should assist her adjustment, thereby also promoting her autonomy. Physician attitudes toward hysterectomy and the hysterectomy patient can have a major influence on patient self-determination.     

Couple interaction: A study of the punctuation process

This study examined couples' punctuation of their own interactions. The association between causal explanations for the interactions on issues involving differences and the nature of relatedness (i.e., degree of distress) was the major purpose of the study. Punctuation was defined as a way of grouping sequences of interactions. Punctuational differneces were operationalized by measuring couples' causal explanations and attributions of responsibility concerning their own interactions. Twenty distressed and non-distressed couples, matched on age, income, education, and length of relationship, participated in an intensive 3-hour interview conducted at their homes. Two relationship measures to determine the degree of distress were administered. The interview involved: generating issues of important differences, improvisational role plays of interactions, responses to open-ended questions about self and other perspectives, and rankings of causal explanations and attributions of responsibility about the interactions. The results suggested that the nature of relatedness, as defined by degree of distress, was associated with the punctuation of interactions by the communicators, tentatively supporting the Watzlawicket al. (1967) metacommunicational axiom. The main finding was that distressed couples attributed responsibility to the mate rather than self, whereas in nondistressed douples responsibility was shared.This article is based on a doctoral dissertation submitted to the University of Massachusetts, Amherst. The senior author is affiliated with the Department of Psychiatry, University of California, San Francisco     

Dissociation, psychopathology, and abusive experiences in a nonclinical Latino university student group

A variety of clinical and experimental data suggest that many individuals who report abusive and traumatic experiences also report a wide array of dissociative and other psychopathological symptoms. In this study, 198 Puerto Rican undergraduate students participated in a study to examine the possible relationship between different types of traumatic experiences and the self-report of dissociative experiences, depressive symptoms, and general psychopathology. Another aspect of this study was the examination of the psychometric properties of the Dissociative Experiences Scale (DES) in a Latino sample. Results supported the hypothesis that those individuals who reported frequent and severe traumatic experiences were also the most likely to experience psychological malaise and scored higher on the DES. Of interest was the finding that the psychometric characteristics of the DES are consistent with those reported in the United States and other countries. The authors conclude that individuals with a marked history of trauma and abuse are more likely to use dissociative defenses as a coping response.     

Relevance of multicultural training to students' applications to clinical psychology programs

Interest in the efficacy of multicultural training for practitioners and scientists working with multicultural populations has led to questions about the characteristics of students who seek this training. Students of ethnic minority background, as compared with White students, may be more likely to seek programs that offer this training, and their ethnic or racial identity may be related to this preference. This study explores the relevance of multicultural training to White and ethnic minority graduate students in accredited clinical psychology programs. Students rated the relevance of multicultural and general training components to their decisions about where to apply to graduate school. The ethnic minority students' mean ratings of the relevance of multicultural components were higher than those of White students, and the degree of ethnic minority students' ethnic identification was positively correlated to these relevance ratings.     

TEMPORAL AND CLIMATIC VARIABLES IN NATURALISTIC OBSERVATION1

Home-observation data on 5- to 7-yr-old boys collected over 2 yr were examined for systematic variations in rates of desirable and undesirable behaviors associated with several temporal and climatic variables. Significant effects associated with time of day, day of the week, precipitation, and temperature were found. No significant effects on the naturalistic observation data were found for environmental factors associated with lunar phase. It was noted that the correlational nature of the findings did not obviate the necessity for control of the influence of temporal and climatic variables. Several methodological strategies for such control were discussed.