THE THERAPEUTIC ALLIANCE IN HOME‐BASED FAMILY THERAPY: IS IT PREDICTIVE OF OUTCOME?

This study examined the association between the therapeutic alliance in family therapy and changes in symptom distress, interpersonal relationships, and family coping. The participants (N = 81) were members of low socioeconomic status families referred to a university clinic for in-home family therapy. Participants completed the Outcome Questionnaire, Family Crisis Oriented Personal Evaluation, and the Family Therapy Alliance questionnaires. Regression analyses revealed that the therapeutic alliance explained 19% of the variance in symptom distress changes for mother, 55% for fathers, and 39% for adolescents. The implications of these findings for practicing and researching family therapy are presented.     

Working children: the health and safety issue

Recent evidence has emerged that in Britain, like the US, many children below the official minimum school leaving age, are working. In many cases, the work is illegal. Research in the US suggests that many working children risk accidents and other hazards to health. Evidence from Britain on the health and safety aspects of child labour is of a more fragmentary nature, but enough exists to suggest a need for greater vigilance.     

The Experience and Practice of Approved Social Workers in Northern Ireland

Correspondence to Dr Roger Manktelow, School of Social and Community Sciences, University of Ulster Magee College, Derry, BT48 7JL, Northern Ireland. Summary This article reports on the first extensive survey of ApprovedSocial Worker (ASW) activity under the Mental Health (NorthernIreland) Order 1986. The integrated health and social servicesorganizational structure, the adverse effects on individualmental health of the legacy of thirty years of civil conflictand the move from hospital to community care are significantfeatures which have influenced the delivery of mental healthsocial work services locally. The practice and experience ofASWs was surveyed by postal questionnaire and user and carerexperience of compulsory hospital admission was investigatedby a series of focus groups. The study revealed that two-thirdsof ASWs had experience of acting as an applicant in compulsoryhospital admission during the past two years. Nearly half (42per cent) of these ASWs had reported experience of between oneand five admissions and one-tenth had completed over twentyadmissions in the two-year period. In only a small minorityof cases did joint face-to-face assessment with the GeneralPractitioner (doctor) take place; nearly half of ASWs reporteddifficulties in obtaining transport; and only one-fifth of ASWshad experience of acting as a second approved social worker.Half of ASWs reported experience of guardianship, either asapplicant or in making the recommendation. Both service usersand carers reported a lack of understanding about the role ofthe ASW and complained about the lack of alternative resourcesthat ASWs could use to prevent hospital admissions. These findingsare discussed and a number of recommendations are proposed forimprovements to approved social worker practice.     

Family Development Cycle,Social Class,and Inequality in Rwanda1

Abstract The relative importance of social class differences (social differentiation) and stages of the family development cycle (demographic differentiation) on income inequalities in rural Rwanda are discussed and compared using survey data from 1,019 households. Both forms of differentiation are conceptualized as dynamic processes that intersect through their mutual inclusion of landholding—land being fundamental to our understanding of social class in the Third World and likewise closely tied to the timing of the developmental stages of the family cycle. Findings demonstrate that both forms of differentiation are vitally important, in roughly equal proportions, to household income generation in Rwanda. Emphasis is placed on the direct effects of the social class variables and on the indirect effects of the demographic differentiation process. The importance of the impact of contextual variables, such as land scarcity and the absence of alternative nonfarm employment, on income inequality are assessed.     

Mood in Daily Contexts: Relationship With Risk in Early Adolescence

Disturbances in affect have been linked to problem behavior in adolescence and future psychopathology, but little is known about how such disturbances manifest themselves in everyday contexts. This study investigated daily mood in Dutch 7th graders, aged 11–14. Cluster analysis of problem measures distinguished high-risk (n=25) and low-risk (n=106) subgroups. Participants completed experience-sampling reports of mood, social context, and location nine times daily for 5 days. Multilevel regression analyses of four mood measures confirmed higher anxiety and depressed mood in the high-risk group. Moods varied by location and social context, with significant differences between groups in two specific social contexts. First, when with family, low-risk adolescents felt less depressed than when alone, whereas high-risk adolescents felt more depressed. Second, high-risk adolescents showed more pronounced anxiety in social situations outside the network of family and friends. These findings point to everyday social contexts in which young adolescents with emotional and behavioral problems appear to be particularly vulnerable.     

Manufacturing in the Nineties By H.J. STRUDEL and P.DESRUELLE(Van Nostrand Reinhold,New York, 1992). £31.50.

Abstract

Looking for a world model for the manufacturing information flow diagram has brought us to the conclusion that it is impossible to build an all-encompassing, all-inclusive system. The redundancy and overlap would make the system excessively complex and ineffective. The best way to generalize a model of this type is to simplify. The result is that we eliminate nearly the entire production control mechanism that is found in the labour intensive MRP system (Fig. 1). We come up with a system that is much closer to the material intensive JIT system (Fig. 2). The conclusion is that effective production control requires that you choose which resource you wish to optimize, and then select a system that controls the plant around the selected resource base. This is the function of books like International Management and Production. A second conclusion would be that complexity (MRP—Fig. 1) gains very little over simplicity (JIT—Fig. 2 or World Model—Fig. 4) in productivity or efficiency. As Shozo Hibino says in his book Breakthrough Thinking, we need to run our plants smarter, not harder.