SOCIAL CLASS AND TACTICS:

This analysis of community opposition to group homes for the mentally handicapped uses data from a survey of New Jersey group home providers. It indicates that deteriorating neighborhoods are most likely to organize in opposition, but that upper-middle class neighborhoods are most likely to enjoy private access to local officials and can, therefore, lobby effectively in opposition to group homes in their neighborhoods. Generally, lower and lower-middle class neighborhoods do not have lobbying privileges and must rely on mass-mobilization, petition campaigns, and other public political tactics that are less effective in influencing local officials. If, however, they gain access to local officials and secure lobbying privileges, they are no less successful than their upper-middle class counterparts in influencing them.     

Nonverbal relational control in family communication

A nonverbal component for an observational coding system of verbal relational control, the Family Relational Communication Control Coding System (FRCCCS; Friedlander & Heatherington, 1989) was developed and validated for research with families or other groups. In so doing, it was demonstrated that nonverbal relational control behaviors can be reliably identified and that these behaviors enhance communicative meaning in predictable ways. First, a pool of nonverbal behaviors with relational control meaning (e.g., head nod, raised eyebrow) was identified from consultation with family therapy researchers and from the literature. Second, the behaviors that were retained from the results of a content validity test were perceived by three independent samples as commonly understood, discrete attempts to either gain control (one-up) or relinquish control (one down) of a social relationship. Still other behaviors were eliminated based on results of a cluster analysis, the interpretation of which was the basis for composing operational definitions for four classes of nonverbal behaviors. Finally, assessments of the interjudge reliability and criterion validity of the nonverbal coding scheme supported its psychometric adequacy. Comparison of effect sizes showed that these discrete nonverbal behaviors accounted for over twice the variance in observers' perceptions as the verbal behaviors.     

Vital Conversations with Family in the Nursing Home: Preparation for End-Stage Dementia Care

Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents' advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia.     

Ethical problems with infertility treatments: Attitudes and explanations

Although media coverage of infertility treatments has increased markedly over the past decade, there is a dearth of empirical information about public perceptions of the ethics of infertility procedures (e.g. artificial insemination, in vitro fertilization, donor eggs, surrogate mothering, and gestational carriers) and about the factors that shape them. Two representative telephone survey samples (930 adults in a Midwestern state, and 580 adult women aged 25–50 in the North Central region) are analyzed to gauge public views on the ethics of infertility treatments and estimate the effects of social structure and exposure on these views. Ethical concerns were viewed as more serious for techniques that could result in a child who may not be biologically related to the woman or her partner than for those yielding a child biologically related to both parents. Social structural factors such as age and education were the strongest predictors of attitudes towards the ethics of infertility treatments. Neither parenthood nor experiencing infertility was related to ethical concerns, although women reporting the use of infertility services had fewer ethical concerns than their counterparts.     

Supervision and Supervision of Supervision,One Perspective

This paper provides one perspective on the theory, structure and process of supervision and supervision of supervision. A case study is provided of the supervision process with one trainee over a six month period of training during which the supervisor also received live supervision of supervision. Three further examples illustrate the use of supervision of supervision in resolving training difficulties.