ATTENDING TO THE CONTEXT OF FAMILY TREATMENT: PITFALLS AND PROSPECTS

This paper argues that family therapy is failing to attend to the contexts in which family mental health services are provided and, therefore, is losing touch with the realities of family services in communities. We present a model for describing the institutional contexts of family mental health treatment in North America, and explore how these contexts influence family treatment. The model proposes that family mental health care can be categorized into three levels, analogous to the levels of the health care delivery system: (a) primary, (b) secondary, and (c) tertiary care. These levels represent systematically different contexts for family treatment; each has unique advantages and limitations. Translating treatment methods across levels can be hazardous because of differences in contexts. We argue that delineating the contextual levels of family mental health care can encourage more fruitful and respectful collaboration among the diverse professional groups working with families.     

Family treatment of a borderline personality

This article discusses family therapy as a complementary treatment modality with the adult borderline patient. According to theory, the separation-individuation process is the underlying conflict of the pathological adaptation of the adult borderline patient and the goal of therapy is often considered to be separation of the patient from the family. Family treatment can facilitate the process of separation-individuation as it allows for the concomitant enhancement of the separateness of the parents. Family treatment can also reduce anxiety about separation, minimize the development of a premature intense transference, and prevent the battle for control between the therapist and the parents. Moreover, the process of the family treatment itself, described in this article, reflects the developmental phase of symbiosis, followed by the subphases of the separation-individuation process, i.e., differentiation, practicing and rapprochement, with the groundwork being laid for moving into object constancy. The ego functioning of all family members has the potential of being enhanced and strengthened through this process.     

Disrespect,Tension, and Togetherness-Apartness in Marriage*

For a study of marital togetherness and apartness, the partners in 136 couples completed questionnaires. The role of disrespect, a factor that might serve as an abrasive in marriage, was investigated. Couples above average on disrespect spent more time apart on days when there had been a big fight, considerable annoyance, or anger; couples below average on disrespect spent more time together on days when there had been a big fight, considerable annoyance, or anger. This finding suggests that therapy for couples with a presenting problem of insufficient contact may first have to deal with abrasive factors.     

FAMILY ASSESSMENT IN CHILD CUSTODY DISPUTES*

This paper has operationalized family systems theory to explicate the interfacing dynamics between family dissolution and child custody disputes. The authors suggest that clinical assessment and intervention in these matters which focus solely on individual and marital, or child dimensions, fail to recognize the powerful influences of systemic family process. A family assessment model, evolved from clinical work with over 200 court-referred custody cases, is described. The model involves a cross-sex therapy team with each member responsible for a specific family subsystem. The role of each therapist and the functioning of the team is outlined. Specific criteria for determining custody recommendations are identified based on patterns of family process and dissolution.     

The development of gender identity: Making sense of the world

A Review of Gender Identities and Education: The Impact of Starting School , by Barbara Lloyd and Gerald Duveen.     

Harriet Tubman's last work: the Harriet Tubman Home for Aged and Indigent Negroes

This article focuses on the important contributions the venerable Harriet Tubman made to the field of housing for older persons and other populations at risk. It uses an historical approach to document the importance of early housing and self-help initiatives in the African American community. It embraces Harriet Tubman and other early housers for their good works and acknowledges them as contributors to the rich legacy of community social work practice and its sage principles of empowerment and self-help. The article presents a nexus between the current housing status of older Blacks and the double jeopardy status imposed by historical discrimination.     

Exiting welfare in the 1990s: Did public policy influence recipients' behavior?

This paper evaluates the association between welfare policies implemented by states in the early to mid-1990s and the rate at which female household heads with children exit AFDC for work or for non-work reasons. The results show that waiver policies requiring work, such as the work requirement and the elimination of exemptions for mothers of very young children, are associated with more rapid exits through employment. Incentive policies that make work more attractive by allowing mothers to remain eligible as earnings rise extend the period of welfare receipt. Neither time limits, the family cap, nor sanctions were related to welfare exits during this early period of welfare reform. Results suggest that other policies implemented in the 1993-1996 period, such as the EITC, may have also influenced welfare exits. In addition, the economy played an important supportive role in facilitating recipient exits from public assistance. While relatively high unemployment rates did not deter recipients from working, state prosperity increased the positive impact of work requirements on work exits.     

Parity-Specific and two-sex utility models of reproductive intentions

This paper uses married couples’ anticipated consequences of having a (another) child to predict their reproductive intentions. Parity-specific models identify different variables as predictors of reproductive behavior at different parities but do not yield interpretable patterns of difference by parity. Parity-specific models are not significantly stronger predictors of reproductive behavior. Generally, wife-only models are distinctly superior to husband-only models. Two-sex models are usually better predictors than one-sex models but not enough better to justify the additional cost.