GAPS between MFT supervision assumptions and common practice: suggested best practices

This article summarizes gaps between assumptions that appear in the literature, research, and accepted standards for marital and family therapy (MFT) supervision, and the common practice of supervisors. Issues that stem from these gaps are highlighted and recommendations are made for closing them. In an effort to refine the standard of practice for MFT supervision, best practice recommendations are offered for MFT supervision.     

Beyond enmeshment: evidence for the independence of intrusiveness and closeness-caregiving in married couples

In a 1996 article on family theory, we (Green & Werner) proposed that family enmeshment should not be equated with high cohesion and that the construct of enmeshment fails to discriminate between two distinct relationship processes: Closeness-caregiving and intrusiveness. In this study, our model of these two independent dimensions of family connectedness was tested by assessing spouses from 264 couples, using the California Inventory for Family Assessment (CIFA). The CIFA scales showed acceptable reliability. Significant interspouse validity correlations also were obtained. As predicted by our theory, factor analyses distinguished dimensions of intrusiveness (blurring of boundaries) from dimensions of closeness-caregiving (such as warmth and nurturance). On all but two factors, behaviors of only one spouse (but not of both) had interpretable loadings. That is, in most areas, the two spouses' behaviors did not load together to form meaningful factors. The latter finding suggests that family systems theory--with its central notion of reciprocally contingent behaviors between family members--may be useful in understanding only a few dimensions of spouses' behavior (such as reciprocal aggression) whereas personality-in-context theories may be better for understanding most other dimensions (such as warmth and nurturance).     

A follow-up study of posttraumatic stress disorder, anxiety, and depression in Australian victims of domestic violence

Although posttraumatic stress disorder (PTSD), anxiety, and depression are acknowledged consequences of domestic violence, little information is available on the course of recovery over time and factors that may mediate positive outcome. Fifty-nine women were assessed for the presence of PTSD and levels of anxiety and depression at time of shelter residence and again one year later. Results at follow-up indicated a significant reduction in the incidence of PTSD, although a substantial number of women continued to report a range of posttrauma symptoms. There were also significant reductions in the levels of anxiety and depression over the 12-month period. Findings indicated the particular importance of safety and the presence of social support as prerequisites for recovery.     

Effects of alcoholic beverage, instigation, and inhibition on expectancies of aggressive behavior

To investigate the role of alcohol expectancy, situational factors, and personality variables in predicting postdrinking aggression, two questionnaire studies were conducted. Subjects were randomly assigned to imagine themselves and their responses in a scenario situation, which was a combination of different beverages (soda vs. alcohol), instigation, and inhibition conditions. Both studies found significant 3-way interactions of personality aggression proneness (Buss-Durkee Hostility Inventory Assault scale) by beverage condition and by situational cue condition on subjects' reported likelihood of engaging in aggressive behavior. Expected aggression was strongly associated with greater aggression proneness in the nonalcoholic condition when there was a situational cue (low inhibition in Study 1, high instigation in Study 2) invoking aggression, but not when the situational cue was absent. This relationship between aggression proneness and expected aggression, however, was attenuated in the alcoholic drink conditions in both studies. In general, it was found that the effect of alcohol on expected aggression was minor relative to the large and significant effects of aggression proneness, instigation, and inhibition.     

Attitudinal acceptance of intimate partner violence among U.S. adults

Attitudinal acceptance of intimate partner violence (IPV) is an important correlate of violent behavior. This study examined acceptance of IPV using data collected from a nationally representative telephone survey of 5,238 adults. Multivariable logistic regression analyses were used to test for associations between sociodemographic characteristics, exposure to violence, question order, and acceptance of hitting a spouse or boyfriend/girlfriend under specific circumstances. Depending on the circumstance examined, acceptance of IPV was significantly higher among participants who were male and younger than 35; were non-White; were divorced, separated, or had never married; had not completed high school; had a low household income; or were victims of violence within the past 12 months. Participants were more accepting of women hitting men; they also were consistently more likely to report tolerance of IPV if they were asked first about women hitting men rather than men hitting women. Reports of IPV tolerance need to be interpreted within the context of the survey. Efforts to change IPV attitudes can be tailored to specific IPV circumstances and subgroups, and these efforts should emphasize that the use of physical violence is unacceptable to both genders.     

Health professional students' occupational exposures to blood-borne pathogens: primary and secondary prevention strategies

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Human resource issues in university health services

To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.     

Upping the ante: relative caregivers' perceptions of changes in child welfare policies

Thirty-five caregivers of related children who were in the custody of the child welfare system were interviewed individually or in focus groups as the state child welfare system implemented new federal and state policies encouraging these caregivers to adopt or assume guardianship of the children in their care. Interviews were transcribed and analyzed using qualitative methods. Issues of concern included emergency entrance into caregiving; the simultaneous satisfaction and burden of caregiving; obstacles to caregiving, adoption, or guardianship; complex changes in family dynamics following placement of children; sources of support; and caution regarding adoption or guardianship. The caregivers also offered recommendations for the child welfare system. Policy, practice, and research implications are discussed.     

Economic change and health benefits: structural trends in employer-based health insurance

Drawing on structural theories of economic outcomes, we investigated how economic change affects the distribution of health benefits, the main source of health insurance for American workers. Through an aggregate level analysis, we show how the effects of industry level characteristics on the level of health benefits change between 1988 and 1997. Due to the increased reliance on women, nonwhite workers, and part-time labor, we expect declines in the effect sizes of gender and race composition and proportion full-time. In contrast, we predict increases in the effects of proportion small firm employment, proportion union, and industry sector due to rising health care costs, the competitive economic environment, and greater union effectiveness. We analyze data from the March Current Population Surveys for 1987 to 1997 using generalized least-squares regression. The positive effect of proportion white increases over time, while the positive effect of level of full-time work declines. The negative effects of small firm employment and being a retail or nonprofessional service industry increase in magnitude. Both union activity and gender composition have stable effects over the period. The results challenge views of a declining significance of race and gender in the labor market.     

Volunteer work and well-being

Using two waves of panel data from Americans' Changing Lives (House 1995) (N = 2,681), we examine the relationships between volunteer work in the community and six aspects of personal well-being: happiness, life satisfaction, self-esteem, sense of control over life, physical health, and depression. Prior research has more often examined the effects of voluntary memberships than of volunteer work, has used cross-sectional rather than longitudinal data, and, when longitudinal, has emphasized social causation over selection effects. Focusing only on the consequences of volunteer work overlooks the antecedents of human agency. People with greater personality resources and better physical and mental health should be more likely to seek (or to be sought for) community service. Hence, we examine both selection and social causation effects. Results show that volunteer work indeed enhances all six aspects of well-being and, conversely, people who have greater well-being invest more hours in volunteer service. Given this, further understanding of self- versus social-selection processes seems an important next step. Do positive, healthy people actively seek out volunteer opportunities, or do organizations actively recruit individuals of these types (or both)? Explaining how positive consequences flow from volunteer service may offer a useful counterpoint to stress theory, which has focused primarily on negative life experiences and their sequelae.