Naked reverse: unexpected plays for exceptional results

Following the herd is easy when it comes to business ventures. But if you really want to start something new, you must first carefully think it through. Learn some ways to do that before you set out on a new path.     

Adapting enactments to couple reactivity: five developmental stages

Interest in change interventions that are common to different models of relationship therapy has spurred investigation of enactments as one such candidate. In change-focused enactments, therapists structure and coach couple/family interaction, as opposed to channeling interaction through the therapist. Still, varying levels of couple/family distress, volatility, and reactivity mean that readiness for enactment intervention varies along a broad continuum and changes over the course of therapy. This suggests the need for differentiated enactments. Currently, however, no model exists for adapting enactments to changing relationship conditions. We propose a five-stage developmental model of clinical operations in couple therapy that adapts the process and structure of enactments to changing levels of relationship distress, interactional volatility, and emotional reactivity. The model increases the possibility for therapists to use enactments successfully over the entire course of couple therapy. Issues to be considered in using the couple enactments model as a template for the development of enactment models for other relationship systems are noted.     

Meta-analysis of MFT interventions

This article briefly reviews 20 meta-analyses of marital and family interventions. These meta-analyses support the efficacy of both MFT for distressed couples, and martial and family enrichment. Those effects are slightly reduced at follow-up, but still significant. Differences among kinds of marital and family interventions tend to be small. MFT produce clinically significant results in 40-50% of those treated, but the effects of MFT in clinically representative settings have not been much studied. The article also introduces the concept of meta-analytically supported treatments (MASTs), which are treatments that meet certain criteria for efficacy in meta-analysis, and which remedy certain problems in the empirically supported treatment (EST) literature. The article concludes with recommendations for doing better meta-analyses.     

Childhood behavioral and emotional disorders

We reviewed the literature on family treatment for childhood behavioral and emotional disorders and found an increase in the number of studies since 1995; however there was significant variation by disorder and therapy model. There is substantially more research on externalizing disorders (i.e., conduct disorder, attention deficit hyperactivity disorder, oppositional defiant disorder) then internalizing disorders, depression and anxiety disorders. The data support the conclusion that family-based interventions produce results comparable to individually oriented interventions, and in some cases family-based interventions are superior to individual treatments. To date, cognitive behavioral family therapy and parent management have been the two models studied, almost exclusively. Implications for family therapy and future research are considered.     

US public universities' compliance with recommended tobacco-control policies

To address the rise in tobacco use among college students, several national health organizations, including the American College Health Association, recommend that colleges enact smoking bans in and around all campus buildings, including student housing, and prohibit the sale, advertisement, and promotion of tobacco products on campus. Key informants at 50 US public universities, one from each state, were interviewed during the 2001/2002 academic year to assess the prevalence of these recommended policies. More than half (54%) of the colleges banned smoking in all campus buildings and student residences, 68% had no tobacco sales on campus, and 32% of the schools' newspapers did not accept tobacco advertising. Regional differences in adoption of these campus tobacco-control policies were present. Although this national sample of public universities had implemented some of the recommended policies, they must take further actions to comply fully with campus tobacco-control guidelines.     

Perceptions of drinking and related findings from the Nationwide Campuses Study

Proponents of social norms approaches maintain that correcting misperceptions of alcohol use among college students may reduce drinking and its consequences. The author used aggregate campus-level data from the Nationwide Campuses Study to test this hypothesis. He defined the misperceptions ratio as the ratio of the frequency of the "average student's" perceived alcohol use to the frequency of self-use at each campus. Each of the 57 colleges reported misperceptions ratios greater than unity. At campuses where students had more accurate perceptions of alcohol use, students were more likely to desire alcohol availability at campus events and to drink on more days throughout the year than at campuses where students had greater misperceptions of alcohol use. The author found no data to support the preferential use of social norms programming on campuses with high levels of self-reported alcohol use or binge drinking. These findings raise questions about potentially unexpected and unintended effects of social norms approaches.     

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.     

Partnering with the 21st century workplace: leveraging workplace ecology

The 'accessible' job market of the 1990's has given way to a challenging job market in a climate of economic uncertainty in the early Twenty-First Century. For vocational rehabilitation professionals this change requires the strategic use of workplace supports to increase the value and sustainability of work performed by people with disabilities in competitive jobs. An analytical framework for leveraging the natural supports of the workplace is provided by the workplace ecology as a bounded environment in which relationships between workers and supervisors promote learning and enhanced performance. The dynamics of the workplace ecology are explored with particular reference to workers with disabilities receiving supported employment services. Recommendations are made for leveraging the workplace ecology to the benefit of the supported worker. Implications for supported employment services in the new millennium are discussed.