THERAPIST-CONDUCTED CONSULTATION: USING CLIENTS AS CONSULTANTS TO THEIR OWN THERAPY

Using qualitative research methodology, the authors developed an in-session therapeutic procedure called the therapist-conducted consultation (TCC) which is designed to enhance the therapist-client collaborative relationship. In the TCC, the therapist and client(s) relinquish their traditional roles and discuss the client's treatment. During this process, clients are invited to (a) share their perspective of treatment, (b) assess whether treatment is meeting their goals, and (c) suggest how treatment could change to improve their experience. The three-stage model of the TCC that resulted from the research is presented with a case example.     

Sensitivity to bodily nonverbal communication as a factor in practitioner-patient rapport

The relationship between physicians' nonverbal sensitivity and the satisfaction of their patients was tested in two field studies. In the first study, 40 physicians were given a film test of nonverbal sensitivity (the PONS test) and were evaluated by their patients. The second study was a replication using 31 additional physicians. Most noteworthy for research in therapeutic interaction, the present studies contained three methodological advances: (1) the use of actual patients' ratings of satisfaction with treatment, (2) the extension of research from psychological to medical settings, and (3) the use of a standardized test of nonverbal decoding skill. Physicians' skill at reading the emotion conveyed through the nonverbal channel of body movement was found to be significantly correlated with their interpersonal success with patients in the clinical setting.The authors would like to thank Donald Dickson, M.D., Mary Ann Spadaro, M.D., Louise M. Prince, John L. Helmuth, Jr., Helene M. Murphy, and the physicians and patients who participated in the research. Study I was supported by a Peter B. Livingston Fellowship from the Massachusetts Mental Health Center and Study II by a W. K. Kellogg Fellowship from the Hospital Research and Educational Trust, both to the senior author.     

COMPETITIVE INDUSTRY EQUILIBRIUM UNDER UNCERTAINTY AND FREE ENTRY

This paper investigates the properties of industry equilibrium under price uncertainty given free entry and exit. For any form of risk-averse behavior, it is shown that an increase in demand uncertainty (as measured by a mean-preserving spread) increases mean output price and reduces output of firms in long-run equilibrium.     

ON THE VALUE OF INTEGRATING APPROACHES TO FAMILY THERAPY

This paper considers the strengths and weaknesses of an integrative approach to family therapy. An integrative approach can explain a broad range of human behavior, can shape intervention strategy in a manner appropriate to each case, can allow for treatment of a broad client population, can combine the strengths of each of the specific approaches, can promote objectivity in selection of strategies of change, and can permit easy expansion of the repertoire of techniques. The potential pitfalls basically revolve around the complexity of practice; in particular, the possibility of inconsistency of approach. With care, these pitfalls can be avoided. Integration is viewed as a viable alternative to school-specific practice in family therapy.     

Formulating the mess: The role of decision aids in problem formulation

Analytic decision aids have been criticized by some practitioners for their inability to address questions of problem formulation. These aids typically begin with the assumption that a problem has been recognized and stated, and that the task of the sequential step-wise analysis process is to indicate the optimal strategy in terms of a specified choice criterion. Writers such as Ackoff, Mason & Mitroff and Raiffa have argued that this approach may lead to solving the wrong problem, particularly when applied to ill-structured, complex organizational decision problems. The purpose of this paper is to provide a more thorough understanding of the nature of problem formulation and the use of techniques for assisting decision-makers in this process. The paper attempts first to develop an understanding of the process of organizational problem formulation through the examination of current literature and research. This is seen to be a necessary prerequisite for discussing the value of decision aids for problem formulation. Second, attention is focused on aids to problem formulation. Included is discussion about the matching of problem to problem type, creativity stimulants, dialectical inquiry and devil's advocate approaches, as well as the role of formal analysis as a stimulant for a policy dialogue process. Finally, the relationships between the various approaches are examined and a synthetic model for their use in problem formulation is suggested.     

Understanding the means and objects of addiction: Technology,the internet,and gambling

This article describes how using new computer technology and the Internet for gambling can represent both the means and object of addiction. However, these technological factors do not represent the cause of addictive behavior. Given the widespread availability of computer technology and the remarkable expansion of the Internet, it is not surprising, however, that these technological advances have become associated with intemperate gambling activities. By discussing the concept of addiction and its associated social setting, neurochemistry, and gaming characteristics, this article suggests that addiction is the result of shifts in subjective experience and that new technology and the Internet can provide relatively reliable and potent contemporary vehicles for changing emotional states.Special thanks are extended to Joni Vander Bilt, Matthew Hall, and Gregory O'Donohue for their helpful comments on earlier versions of this article.