Family Intervention and Health Care Costs for Kansas Medicaid Patients with Schizophrenia

Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).     

The influence of marital and family therapy on health care utilization in a health-maintenance organization

Research has shown that people reduce their use of health care after individual psychotherapy. However, little research has been done to learn if marital and family therapy has a similar effect. Subjects (n = 292) from a health-maintenance organization were randomly selected according to the type of therapy they had received. Subjects' medical records were examined for 6 months before, during, and after therapy. Those who received marital and family therapy significantly reduced their use of health care services by 21.5%. These results show an "offset effect" for marriage and family therapy.     

Cultural Sociology and Other Disciplines: Interdisciplinarity in the Cultural Sciences

The subject of this article is the relationship between cultural sociology and approaches to culture in other social science disciplines. What are the characteristics of the theoretical environment, in which cultural sociology is operating? The article begins by reviewing the literature on interdisciplinarity. Many authors argue that interdisciplinarity is increasing or should be increasing, but the general consensus is that disciplinary isolation is the norm. From this perspective, the relationships between disciplines can be understood in terms of trading zones, in which fields in different disciplines have little in common, theoretically, or empirically. Interdisciplinary communication in ‘trading zones’ requires that participants laboriously construct a set of terms that permits them to exchange ideas. Alternatively, I propose that clusters of fields in different disciplines are linked by free-floating paradigms. Participants in disciplines that share ‘free-floating paradigms’ are able to communicate with one another more readily. The article presents evidence for the second interpretation, drawn from survey articles in disciplinary handbooks. Disciplines and fields in which the study of culture draws from the same pool of paradigms and models and shares a set of lines of inquiry with cultural sociology include traditional disciplines, such as anthropology, communication, geography, history and psychology, and interdisciplinary fields, such as cultural studies, communication, feminist theory, material culture, science studies, and visual culture. Interdisciplinary fields – particularly cultural studies – perform an important role in diffusing paradigms across disciplinary boundaries. Free-floating paradigms are associated with the work of major theorists, such as Lévi-Strauss, Barthes, Foucault, Bourdieu, Lyotard, Baudrillard, Clifford Geertz, Bruno Latour, Adorno, Gramsci, and Habermas.     

MORNING AND NIGHT COUPLES: THE EFFECT OF WAKE AND SLEEP PATTERNS ON MARITAL ADJUSTMENT*

This study explored the effects of spouses' wake and sleep patterns on marital adjustment. A total of 150 couples from three states completed questions on wake/sleep patterns, marital interaction, marital adjustment, and problem solving. Couples whose wake and sleep patterns were mismatched (e.g., an evening person married to a morning person) reported significantly less marital adjustment, more marital conflict, less time spent in serious conversation, less time spent in shared activities and less frequent sexual intercourse than matched couples. Contrary to expectations for matched couples, night couples did not report more involvement in extra-familial social activities than morning couples. Morning couples engaged in sexual intercourse more frequently in the morning than night couples; night couples had sex more often in the evening than morning couples. There were no significant differences in the intercourse rates for morning couples and night couples. Compared to matched couples, mismatched couples with high marital adjustment reported more flexibility and adaptability in their marital problem solving. The implications of these findings for premarital counseling and marital therapy are discussed.     

INFLUENCE OF THERAPIST SKILLS ON CLIENT PERCEPTIONS OF MARRIAGE AND FAMILY THERAPY OUTCOME: IMPLICATIONS FOR SUPERVISION

Clients seen in two marriage and family therapy training clinics were surveyed regarding treatment outcome. They rated their therapist's skill level on several therapist variables including "experience,""confident,""concerned," how well the treatment used seemed to "fit" their view of the problem and if the therapist seemed to "know how to deal" with their concerns. The variable of "fit" of treatment accounted for 35% of the variance in the client's perception of treatment outcome. "Concerned,""fit," and "knew how to deal" accounted for 36% of the variance in overall rating of the therapist. Suggestions for using these results in supervision of beginning therapists are given.     

An Empirical Approach to Supervision and Training of Relationship Therapists

This paper presents an empirical approach to supervision and training of marriage and family therapists. Advantages from the use of the empirical approach include a systematic investigation of the skills and competencies of the therapist and establishing the basis for the scientific study of supervision. A Counseling Problems Worksheet is presented to help in developing multiple hypothesis related to counselor skill deficiencies. Two case studies are given to demonstrate the use of the empirical approach .     

GENDER AND HEGEMONY IN FASHION MAGAZINES:

Women's responses in the context of focus groups to fashion photographs and clothing advertisements in Vogue magazine and to a brief questionnaire eliciting their attitudes toward clothing and fashion are used to examine the nature and extent of hegemonic influences in fashion. Participants' sources of information about fashion suggest that the authority of the fashion press is limited. The magazine's conceptions of women's roles as expressed in its fashion photography fit a model of "conflicted" hegemony characteristic of American media and popular culture in general. Empowered by the cultural context of conflicted hegemony, women were generally critical of fashion photographs. Their responses to photographs were influenced by their acceptance of traditional norms of feminine demeanor but varied by age and race. They rejected the magazine's orientation toward the use of fashionable clothing for postmodernist roleplaying in favor of a modernist outlook.