The impact on the family therapist of a focus on death, dying, and bereavement

Recognizing the growing numbers of family therapists who are choosing a focus on death, dying, and bereavement, this article addresses the nature of the commitment required--as well as the gifts and challenges presented by work in this area. Particular attention is given to therapists' vulnerability to compassion fatigue and/or vicarious traumatization, both of which are described and discussed. A variety of strategies for individuals and institutions, aimed at supporting professionals and preventing problems, are considered. It is concluded that as family therapists focus on self-care as well as client care, they have the potential to increase not only their effectiveness but also to enhance their own well-being. Implications for training and for research on this topic also are considered.     

Multi-family psychoeducation groups in the treatment of children with mood disorders

This study examined the impact of adjunctive multi-family psychoeducation groups (MFPG) on mood-disordered children aged 8 to 11 and their families. Participants were 35 children and 47 parents from families randomly assigned to either immediate MFPG plus treatment as usual (n = 18) or a 6-month wait-list condition plus treatment as usual (n = 17). At the 6 month follow up, immediate treatment families reported: Increased parental knowledge about childhood mood symptoms; increased positive family interactions as reported by the parent; increased perceptions of parental support as reported by children; and increased utilization of appropriate services by families. Expected impact on decreasing negative family interactions was not found. Results are largely consistent with hypothesized findings and support the need to further investigate the adjunctive role of psychoeducation in the treatment of childhood mood disorders.     

Using "short" interrupted time-series analysis to measure the impacts of whole-school reforms. With applications to a study of accelerated schools

The present article introduces a new approach for measuring the impacts of whole-school reforms. The approach is based on "short" interrupted time-series analysis, which has been used to evaluate programs in many fields. The approach is used to measure impacts on three facets of student performance: (a) average (mean) test scores, which summarize impacts on total performance; (b) the distribution of scores across specific ranges, which helps to identify where in the distribution of student performance impacts were experienced; and (c) the variation (standard deviation) of scores, which indicates how the disparity in student performance was affected. To help researchers use the approach, the article lays out its conceptual rationale, describes its statistical procedures, explains how to interpret its findings, indicates its strengths and limitations, and illustrates how it was used to evaluate a major whole-school reform--Accelerated Schools.     

Cultural perspectives of death,grief, and bereavement

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.     

More harm than good? Diagnostic codes for child and adult abuse

This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.     

Gamma-secretase--intramembrane protease with a complex

Gamma-secretase catalyzes intramembrane proteolysis of the amyloid beta protein precursor, a process closely linked to the development of Alzheimer's disease. This protease also cleaves the transmembrane domain of the Notch receptor as part of a signaling pathway that is essential for proper embryonic development. Recent findings suggest that gamma-secretase is a complex of at least four integral membrane proteins: presenilin, nicastrin, Aph-1, and Pen-2. Assembly of these four components apparently leads to autocleavage of presenilin into two subunits that together compose the intramembranous active site of gamma-secretase. Understanding the mechanism of this unusual enzyme is important, as it is both a key therapeutic target and a founding member of a newly discovered class of intramembrane-cleaving proteases.     

Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

An analysis of VDT monitor placement and daily hours of use for female bifocal users

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are correlated with hours of VDT work and that there appears to be a threshold at approximately five hours for pain symptoms among bifocal wearers. No such correlation can be made for monitor placement     

Women and class structure in contemporary Japan

The main purpose of this study is to examine how to determine the class position of women, especially married women, in Japan. This study examines three different approaches to conceptualizing women's position in the class structure: the conventional approach, the individual approach, and the dominance approach. Since 1975, the overall rate of female labour force participation in Japan has increased, and given this growth, particularly of employees working outside home, I discuss whether the increased entry of women, particularly married women, into the labour market challenges the conventional way of assigning class positions to women by simply deriving them from their husband's class positions. The data set used in this study is derived from the 1995 Japanese Social Stratification and Mobility Survey. An examination of class distributions suggests that the pictures of macro-class structure provided by the conventional approach and the dominance approach show very little difference. Married women who belong to the female-dominant family still form a very small minority of all married women in the society. Furthermore, the male-dominant family shows the greatest stability over the life course whereas the female-dominant family, where the wife experiences withdrawal from the labour market, is least stable. The increasing number of married women in the labour market, thus, has not yet become a major threat to the conventional way of assigning women to a class position in contemporary Japan. Women, even among those working on a full-time basis, perceive their position in the stratification system using not only their own work, but also their husband's. In contrast, men's perception is determined by their own education and employment, not by their wives'. This asymmetry in the effect of the husband's class and of the wife's class on class identification is related not only to gender inequality within the labour market but also to the division of labour by gender within the household.