bluuebunny/crossref_metadata_2025 huggingface dataset:
The Changing Profile of Patient Selection, Procedural Techniques, and Outcomes in Excimer Laser Coronary Angioplasty
Authors: BITTL JOHN A. , BRINKER JEFFREY A. , SANBORN TIMOTHY A. , ISNER JEFFREY M. , TCHENG JAMES E.
Published: June 2007

During the course of development of excimer laser angioplasty, several changes in patient selection and technique have occurred. It is uncertain, however, whether these changes have been associated with improved procedural outcome. In this study, multivariable regression methods were used to identify the factors responsible for clinical success, major complications, and vessel perforation in 2,041 consecutive patients treated with excimer laser coronary angioplasty. The overall rates of clinical success were 89%, major complications 7.5%, and vessel perforation 2.1%. Clinical success was 86% in patients treated with prototype catheters, 89% with flexible catheters, 92% with extremely flexible catheters, and 95% in patients treated with directional eccentric catheters (P < 0.001). By multivariable analysis, clinical success increased with each subsequent catheter design (odds ratio [OR] = 1.4 per iteration [95% confidence interval 1.2, 1.6]), and with improved lesion selection. Major complications were reduced when operators had performed more than 25 cases (rate = 6.5%, OR = 0.7 [0.5, 0.9]), and the incidence of vessel perforation was decreased when the size of the target vessel was > 1.0 mm larger than the diameter of the laser catheter (rate = 1.1%, OR = 0.3 [0.2, 0.5]). In conclusion, during the course of clinical investigation with excimer laser angioplasty, procedural outcome has improved. These results emphasize the importance of careful patient selection and procedural technique to enhance the success of excimer laser angioplasty.
Transluminal Angioplasty, Thrombolysis, and Stenting for Extracranial and Intracranial Cerebral Vascular Disease
Authors: HIGASHIDA RANDALL T. , TSAI FONG Y. , HALBACH VAN V. , DOWD CHRISTOPHER F. , HIESHIMA GRANT B.
Published: June 2007

Percutaneous transluminal angioplasty, alone or in conjunction with thrombolysis and/or stenting, is now being performed in selected cases for hemodynamically significant stenosis (> 70%), involving both extracranial and intracranial cerebral vascular lesions. In the majority of cases, atherosclerosis was the major cause for symptomatic narrowing, although other causes included fibromuscular dysplasia, cerebral arteritis, postsurgical intimal hyperplasia, and acute arterial dissection. In some cases, direct intraarterial thrombolysis and angioplasty successfully restored perfusion to completely occluded blood vessels to the brain, and in other cases acute vessel closure or dissection of extracranial vessels was successfully managed with stent deployment. Since 1981, 325 patients, ranging in age from 9–78 years old, have been successfully treated by these techniques: 143 (44%) cases involved the anterior cerebral circulation; and 182 (56%) cases, the posterior cerebral circulation. Complications included 17 (5.2%) strokes (of which 4 [1.2%] died), and 23 (7.1%) cases of transient cerebral ischemia. Radiological follow‐up demonstrated 24 (7.4%) cases of restenosis. This study indicates the feasibility of angioplasty as a treatment alternative, in conjunction with thrombolysis and intravascular stenting, for extracranial and intracranial obstructive cerebral vascular disorders and may also provide an interventional pathway in the treatment of acute stroke patients.
Structure of a human telomeric DNA sequence stabilized by 8‐bromoguanosine substitutions, as determined by NMR in a K+ solution
Authors: Matsugami Akimasa , Xu Yan , Noguchi Yuuki , Sugiyama Hiroshi , Katahira Masato
Published: June 2007

The structure of human telomeric DNA is controversial; it depends upon the sequence contexts and the methodologies used to determine it. The solution structure in the presence of K+ is particularly interesting, but the structure is yet to be elucidated, due to possible conformational heterogeneity. Here, a unique strategy is applied to stabilize one such structure in a K+ solution by substituting guanosines with 8‐bromoguanosines at proper positions. The resulting spectra are cleaner and led to determination of the structure at a high atomic resolution. This demonstrates that the application of 8‐bromoguanosine is a powerful tool to overcome the difficulty of nucleic acid structure determination arising from conformational heterogeneity. The obtained structure is a mixed‐parallel/antiparallel quadruplex. The structure of telomeric DNA was recently reported in another study, in which stabilization was brought about by mutation and resultant additional interactions [Luu KN, Phan AT, Kuryavyi V, Lacroix L & Patel DJ (2006) Structure of the human telomere in K+ solution: an intramolecular (3+1) G‐quadruplex scaffold. J Am Chem Soc 128, 9963–9970]. The structure of the guanine tracts was similar between the two. However, a difference was seen for loops connecting guanine tracts, which may play a role in the higher order arrangement of telomeres. Our structure can be utilized to design a small molecule which stabilizes the quadruplex. This type of molecule is supposed to inhibit a telomerase and thus is expected to be a candidate anticancer drug.
Randomized controlled trial of an instructional DVD for clinical skills teaching
Authors: Lee Joon C , Boyd Russell , Stuart Peter
Published: June 2007

Objective:  To determine the efficacy of clinical skills teaching using a DVD‐based teaching medium (interventional group) compared with the traditional, four‐step, face‐to‐face approach (control group). The clinical skill selected for the study was that of paediatric intraosseous (IO) needle insertion.

Methods:  Thirty‐six candidates who had no exposure to IO needle insertion experience within the past 12 months were randomly allocated into two groups. The interventional group (n = 18) was shown a 10 min instructional DVD and then allowed 10 min each to practise IO insertion with a paediatric training mannequin. The control group (n = 18) was given a 20 min, four‐step, face‐to‐face teaching session with practical exposure and individual use of an IO needle on a training mannequin facilitated by an instructor. Each candidate was assessed using a checklist of critical steps for successful IO needle insertion and given a score out of 10. A modified Likert score reflecting candidates’ subjective perceptions of the whole experience was completed after the test.

Results:  The interventional group obtained a mean score of 7.56 (SD 1.65) and the control teaching group a mean score of 6.00 (SD 1.84). The mean difference was −1.56 (P < 0.01, 95% CI −2.74 to −0.37). There was no difference in the candidates’ perception on the satisfaction, anxiety and confidence level about the teaching experience.

Conclusion:  The study suggests that the use of instructional DVD for clinical skills teaching results in improved learning outcomes compared with the traditional face‐to‐face didactic teaching method.
Rural Hospital Patient Safety Systems Implementation in Two States
Authors: Longo Daniel R. , Hewett John E. , Ge Bin , Schubert Shari
Published: June 2007

ABSTRACT: 
Context and Purpose:

With heightened attention to medical errors and patient safety, we surveyed Utah and Missouri hospitals to assess the “state of the art” in patient safety systems and identify changes over time. This study examines differences between urban and rural hospitals.

Methods:

Survey of all acute care hospitals in Utah and Missouri at 2 points in time (2002 and 2004). Factor analysis was used to develop 7 latent variables to summarize the data, comparing rural and urban hospitals at each point in time and on change between the 2 survey times.

Findings:

On 3 of the 7 latent variables, there was a statistically significant difference between rural and urban hospitals at the first survey, with rural hospitals indicating lower levels of implementation. The differences remained present on 2 of those latent variables at the second survey. In both cases, 1 of those variables was computerized physician order entry (CPOE) systems. Rural hospitals reported more improvement in systems implementation between the 2 survey times, with the difference statistically significant on 1 of the 7 latent variables; the greatest improvement was in implementation of “root cause analysis.”

Conclusions:

Adoption of patient safety systems overall is low. Although rates of adoption among rural versus urban hospitals appear lower, most differences are not statistically significant; the gap between rural and urban hospitals relative to quality measures is narrowing. Change in rural and urban hospitals is in the right direction, with the rate of change higher in rural hospitals for many systems.
Risk Factors for Rural Residential Fires
Authors: Allareddy Veerasathpurush , Peek‐Asa Corinne , Yang Jingzhen , Zwerling Craig
Published: June 2007

ABSTRACT: 
Context and Purpose

: Rural households report high fire‐related mortality and injury rates, but few studies have examined the risk factors for fires. This study aims to identify occupant and household characteristics that are associated with residential fires in a rural cohort.

Methods

: Of 1,005 households contacted in a single rural county, 691 (68.8%) agreed to participate. One household with missing information on a reported fire was excluded from the analysis. We used logistic regression to examine the independent association of occupant and household characteristics with reported fires, controlling for years lived in the residence. We also examined the association between the occurrence of previous fires and the adoption of safety measures.

Findings

: A total of 78 (11.3%) households reported a residential fire. Occupant characteristics that were associated with significantly higher odds of reported fires included the presence of an occupant with alcohol problems (OR = 1.82, 95% CI = 1.01‐3.28) and being married (OR = 2.11, 95% CI = 1.14‐3.91). Rural farm households were associated with significantly higher odds (OR = 1.72, 95% CI = 1.01‐2.93) of reporting a fire when compared to residences in towns, after controlling for all other occupant and household characteristics. The presence of a fire extinguisher (OR = 2.00, 95% CI = 1.10‐3.64) was the only fire safety measure that had a statistically significant association with reported fire.

Conclusion

s: Rural farm households report higher incidences of fire when compared to households located in towns. Experiencing a fire is not associated with an increased likelihood of adopting safety measures to prevent injuries once a fire has started.
Health Communications in Rural America: Lessons Learned from an Arthritis Campaign in Rural Arkansas
Authors: Balamurugan Appathurai , Rivera Mark , Sutphin Kim , Campbell Debbie
Published: June 2007

ABSTRACT: 
Context:

Lack of awareness about diseases and associated risk factors could partially account for some rural health disparities. Health communications campaigns can be an effective means of increasing awareness in these areas.

Purpose:

To review findings and lessons learned from a rural health communications campaign.

Methods:

The health communications campaign titled “Physical Activity. The Arthritis Pain Reliever,” developed by the Centers for Disease Control and Prevention, was implemented in a rural Arkansas county to promote awareness about arthritis and the beneficial effects of physical activity among residents 45‐64 years of age with arthritis. The campaign was implemented through radio spots, print ads in local newspapers, and distribution of brochures and posters. A survey of 193 residents with arthritis assessed the reach of the campaign.

Findings:

Whereas 86% of respondents reported having seen or heard the messages related to arthritis during the 13‐week period of the campaign, only 11% recalled messages from the “Physical Activity. The Arthritis Pain Reliever” campaign. Challenges faced during campaign implementation included limited fiscal resources, distrust, and staff and time constraints.

Conclusion:

Challenges to health communications campaigns in rural areas can decrease campaign reach and effectiveness. If resource constraints exist, leveraging partnerships and building trust among residents of the community are important for achieving campaign success.
Clinical efficacy and safety of cefovecin in the treatment of canine pyoderma and wound infections
Authors: Stegemann M. R. , Coati N. , Passmore C. A. , Sherington J.
Published: June 2007

Objectives:To determine the efficacy and safety of cefovecin in the treatment of bacterial skin infections in dogs.

Method:Dogs with superficial or deep pyoderma or wounds/abscesses were enrolled in three separate studies. Dogs (354) were randomised to treatment and received either cefovecin administered by subcutaneous injection at 14 day intervals, as clinically necessary, or amoxicillin/clavulanic acid as oral tablets twice daily for 14 days. Courses of treatment were repeated at 14 day intervals up to a total of four courses. Clinicians responsible for assessing lesions were masked to treatment allocation. Only animals where the presence of a pretreatment bacterial pathogen was confirmed were included in the analysis of efficacy. Cases were evaluated for clinical efficacy at 28 days after initiation of the final course of treatment. Clinical efficacy was assessed by scoring the clinical signs typical of skin infections.

Results:Cefovecin demonstrated statistical non‐inferiority compared with amoxicillin/clavulanic acid for all three clinical diagnoses; for cefovecin, up to 96·9 per cent efficacy was observed versus 92·5 per cent for amoxicillin/clavulanic acid.

ClinicalSignificance:Cefovecin was shown to be as effective as amoxicillin/clavulanic acid administered orally in the treatment of bacterial skin infections in dogs. Cefovecin offers the additional benefit of eliminating owner non‐compliance.
PUPPING HABITAT USE IN THE MEDITERRANEAN MONK SEAL: A LONG‐TERM STUDY
Authors: Dendrinos Panagiotis , Karamanlidis Alexandros A. , Kotomatas Spyros , Legakis Anastasios , Tounta Eleni , Matthiopoulos Jason
Published: June 2007

Abstract

The Mediterranean monk seal gives birth almost exclusively in coastal caves. Given its critical conservation status, the identification and protection of such sites is important for the survival of the species. From 1990 to 2004 we collected data on physical and environmental variables and monitored pupping events in thirty‐four coastal caves in Greece. We modeled the probability of cave occupancy as a function of the properties of each cave. Model selection and model averaging enabled us to rank the variables that influenced use of potential pupping sites. Environmental variables related to cave seclusion, substrate, and degree of protection from wind and wave action were the most important among them. The relative importance and directions of these relationships confirm the long‐standing assumption that Mediterranean monk seals require sheltered pupping sites, far from sources of human disturbance and thus are progressively limited to isolated parts of the country's coastline. We used cross‐validation to examine the predictive ability of our analysis and quantified the sensitivity of our predictions to the degree of extrapolation. We conclude that, although more data are required, the model is capable of predicting occupancy for caves close to the middle of the environmental space examined in this study.
Projection and Misperception in Couples Treatment
Authors: Mannino Fortune V. , Greenspan Stanley I.
Published: June 2007

Projective identification is discussed as an interpersonal mechanism involved in distortions of perceptions and communications. Several case illustrations are presented to show how this mechanism manifests itself in relatively healthy, though neurotic, couples. A treatment approach based on correction of the perceptual distortions is suggested as a model for short‐term counseling with such couples.
Enriching Research on Marital Enrichment Programs
Authors: Gurman Alan S. , Kniskern David P.
Published: June 2007

The existing empirical literature on the outcomes of marital and pre‐marital enrichment programs is critically reviewed. While the majority of studies have used untreated control groups and appear to offer very striking evidence of meaningful change as a result of these enrichment experiences, several important methodological deficiencies are common to these investigations and, therefore, require a cautious optimism about the efficacy of these programs. Six specific issues are addressed in an effort to improve the quality and utility of further research and practice in this area.
Family Therapy with the Learning Disabled Child and His/Her Family
Authors: Kaslow Florence W. , Cooper Bernard
Published: June 2007

No therapist can come in contact with and treat children with minimal brain damage or specific learning disabilities without being struck by the fact that there are numerous intertwined factors that have contributed to and continue to perpetuate the problems. In addition to the helping approaches which have been utilized in recent years, such as tutoring, special education, and child therapy, this article elaborates the importance of utilizing family therapy as the treatment of choice sometime during the course of treating the child and helping the parents to understand and deal with their handicapped youngster.
The Role of Death in the Addict Family
Authors: Coleman Sandra B. , Stanton M. Duncan
Published: June 2007

Drug addiction is a potentially life‐threatening problem with suicidal ramifications. Within the family of the addict, the addiction takes on a special, participatory meaning; the addicted member is treated as one undergoing a slow death. These families attach special significance to death and give it considerable emphasis. This appears to arise from unresolved and premature deaths experienced by the family, particularly the parents. The addict is substituted for the deceased member. Treatment can deal with these issues directly through making the mourning explicit. The death issue can also serve as a vehicle for family change.
The McMaster Model of Family Functioning
Authors: Epstein Nathan B. , Bishop Duane S. , Levin Sol
Published: June 2007

The model of family functioning being presented is the product of over twenty years of research in clinical work with family units. A method of family therapy has been developed based upon this model and will be described in a future issue. The model utilizes a general systems theory approach in an attempt to describe the structure, organization, and transactional patterns of the family unit. It allows examination of families along the total spectrum ranging from healthy to severely pathological in their functioning. It is based upon a Judaeo‐Christian value set, and allows attention to be paid to cultural differences and other issues of cultural relativity.
Salvete et Valete: On Saying Goodbye to a Deceased Former Parent*
Authors: Taggart Morris
Published: June 2007

Following Bowen's lead, a number of family therapists have shared accounts of their efforts at defining themselves in their families‐of‐origin. Some reports have been anecdotal in form, while others have been research oriented, with considerable theoretical exposition as to strategy and tactics. This report is neither. With a style more akin to that of the memoir, the paper deals with contacts between the writer and his family‐of‐origin over many years, the death of the writer's father providing the initial impetus.
A Curriculum for Graduate‐Level Marriage and Family Therapy Education*
Authors: Winkle C. Wayne , Piercy Fred P. , Hovestadt Alan J.
Published: June 2007

The Delphi technique of refining group opinion was used to develop a graduate level marriage and family therapy curriculum. Opinions were synthesized from a national panel of 20 AAMFT Approved Supervisors and 25 training directors of graduate‐level marriage and family therapy programs. Three rounds of questionnaires were employed and 101 content areas met the criteria for inclusion into the final curriculum. Discussed are the similarities and differences of this curriculum and the current “model” AAMFT curriculum. It is hoped that the curriculum devised from this study will lead to the continued rethinking, refinement, and evolution of marriage and family therapy education.
A Systems Model of Family for Family Therapists*
Authors: Beavers W. Robert
Published: June 2007

A family model that provides a classification system for family therapists is presented, based on an integration of family systems research in healthy and disturbed families and clinical data. The model provides tools for cross‐sectional, process‐oriented family assessment derived from consideration of family competence in task performance and family operating style. Seven family types result‐optimal, adequate, midrange centripetal, midrange centrifugal, midrange mixed, severely dysfunctional centripetal and severely dysfunctional centrifugal. Identifying characteristics of each type are provided, and intervention strategies and approaches are discussed that follow logically from the assessment.
A Diaclectic Approach to Family Therapy and Practice: Selectivity and Synthesis
Authors: Kaslow Florence W.
Published: June 2007

In this article, a case is made for transcending any one model or theory, or any reliance on particular techniques as a panacea. Instead, new integrations of intuitive understanding, which represent the artistry of healing, and of scientific knowledge of various theories, in a spontaneous and therefore unique responsiveness to the specific family requesting help are sought. In this way, the most growth oriented and change producing therapeutic environment is created.
Unshared Loss and Marital Conflict*
Authors: Derdeyn Andre P. , Waters David B.
Published: June 2007

The authors have noted in marital therapy a pattern wherein a variety of losses are not mourned and are not shared between partners; instead one spouse uses the other for externalization of internal conflict regarding the losses. Loss is neither acknowledged nor mourned, but tends to be experienced as disenchantment with and anger at the spouse.

Therapy should entail the sorting out of projections so that the person can resume the ownership of his or her problems. The conjoint format is helpful for dealing adequately with projective distortions; more importantly, it can facilitate mourning and the sharing of losses.
Teaching Family Therapy: A Program Based on Training Objectives
Authors: Falicov Celia J. , Constantine John A. , Breunlin Douglas C.
Published: June 2007

This paper presents a set of specific training objectives which constitute a base for a one‐year clinical training program at the Institute for Juvenile Research in Chicago. The training objectives include three categories of skills: observational, conceptual, and therapeutic. The training objectives and the program in which they are implemented are described.
LEARNING TO “THINK SYSTEMS”: FIVE WRITING ASSIGNMENTS
Authors: Green Robert Jay , Saeger Karen E.
Published: June 2007

This paper describes five highly structured writing assignments for teaching family therapy trainees to think in systems terms: 1) Analysis of a communication task; 2) Family assessment report; 3) Family treatment plan; 4) Analysis of a marital or family therapy interview; and 5) Family autobiography. The overall training context in which the assignments are given and ways to prepare students for the assignments are also discussed.
PERSONAL AUTHORITY IN FAMILY EXPERIENCE VIA TERMINATION OF THE INTERGENERATIONAL HIERARCHICAL BOUNDARY: PART III—PERSONAL AUTHORITY DEFINED, AND THE POWER OF PLAY IN THE CHANGE PROCESS
Authors: Williamson Donald S.
Published: June 2007

Present transgenerational family therapy theory is analyzed, and it is suggested that individuation is on a continuum with fusion‐triangulation (family systems theory), that relational ethics are on a continuum with invisible loyalties (contextual family therapy), and that there is in fact but one continuum, so that these terms are well‐nigh interchangeable. Individuation‐relational ethics is presented in a (Hegelian) dialectic with intimacy; and personal authority in family experience is offered as the synthesizing construct in this dialectic. The change process in transgenerational family therapy is briefly noted. It is suggested that playfulness, including paradox and absurdity, is an effective intervention into the intense emotionality of inter generational work. A framework for and sequence of playful interventions are described.
DYSFUNCTIONAL MARITAL CONFLICT: AN INTEGRATIVE INTERPERSONAL‐INTRAPSYCHIC MODEL*
Authors: Feldman Larry B.
Published: June 2007

An integrative interpersonal‐intrapsychic model of dysfunctional marital conflict is presented and research support for the model is reviewed. The therapeutic applications of the model are discussed and illustrated with a clinical example.
THE McMASTER FAMILY ASSESSMENT DEVICE*
Authors: Epstein Nathan B. , Baldwin Lawrence M. , Bishop Duane S.
Published: June 2007

This paper describes the McMaster Family Assessment Device (FAD), a newly developed questionnaire designed to evaluate families according to the McMaster Model of Family Functioning. The FAD is made up of seven scales which measure Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement, Behavior Control and General Functioning. The paper describes the procedures used to develop the FAD and presents scale means and scale reliabilities from a sample of 503 individuals.
A MODEL FOR TRAINING PRACTICING PROFESSIONALS IN FAMILY THERAPY*
Authors: Wendorf Donald J.
Published: June 2007

This paper offers a model for high quality training in family therapy. The unique aspects of the Family Consortium's model are that it: (a) is aimed at practicing professionals; (b) emphasizes structural family therapy principles with strategic and experiential elements; (c) is geared secondarily toward training members as effective peer consultants and trainers; and (d) uses an awareness of the isomorphic nature of training, therapy and family transactions. Part I describes the practical organization structure of the Consortium. Part II discusses the current theoretical philosophy and training approach of this evolving group. Examples are given of how the Consortium has dealt with specific training issues.
THE McMASTER FAMILY ASSESSMENT DEVICE: RELIABILITY AND VALIDITY*
Authors: Miller Ivan W. , Epstein Nathan B. , Bishop Duane S. , Keitner Gabor I.
Published: June 2007

This paper reports a series of studies investigating the reliability and validity of the McMaster Family Assessment Device (FAD). The results indicated that the FAD has: (a) adequate test‐retest reliability, (b) low correlations with social desirability, (c) moderate correlations with other self‐report measures of family functioning, and (d) differentiates significantly between clinician‐rated healthy and unhealthy families. Cut‐off scores for identifying healthy and unhealthy families also were developed which have adequate sensitivity and specificity. Additionally, the relationships between the FAD, Family Unit Inventory, and FACES‐II suggests that the cohension and adaptability scales from the FACES‐II have a linear relationship with health/pathology.
LEAVING THE CONSULTING ROOM TO PROVOKE ENACTMENT IN MARITAL THERAPY*
Authors: Hamburg Sam R.
Published: June 2007

Enactment of emotionally intense, intimate behaviors is often important in marital therapy. But clients' concerns for privacy and their dependence on the therapist as a facilitator of communication can deter them from exhibiting such behavior in the therapist's presence. By walking out of the consulting room, the therapist can stimulate the enactment that would have been inhibited otherwise. Three case examples illustrate the technique. Specific points of procedure are considered, and the technique's limitations and risks are noted.
GROWTH BEHIND THE MIRROR:, THE FAMILY THERAPY CONSORTIUM'S GROUP PROCESS
Authors: Wendorf Donald J. , Wendorf Robert J. , Bond David
Published: June 2007

An earlier paper (Wendorf, 1984) presented the pragmatic aspects and theoretical model of The Family Therapy Consortium, a group set up to provide supervision and continuing education in family therapy. The emphasis was on the development of each individual therapist's competency, the isomorphic relationship between the supervisor, group, therapist, and family levels of the therapeutic system, and the legitimacy of the term “peer supervision.” Beginning under the leadership of an expert supervisor hired from outside the group, the Family Therapy Consortium has developed into a peer supervision group with a “floating,” rather than fixed, supervisory hierarchy. The present paper charts this development and explores the peer supervision process as it currently works in the Consortium. The focus is on the growth of the individual behind the mirror as therapist, person, leader and group member, and on the growth of the group as a “mature sibling subsystem” no longer in need of outside supervision. Individual and group development are seen as complementary aspects of the same growth process.
PSYCHOTHERAPY WITH LESBIAN COUPLES: INDIVIDUAL ISSUES, FEMALE SOCIALIZATION, AND THE SOCIAL CONTEXT*
Authors: Roth Sallyann
Published: June 2007

Relationship patterns in lesbian couples vary systematically from relationship patterns in heterosexual couples in ways that are related to the exclusively female composition of these couples, their stigmatizable identity, and the lack of social recognition and acceptance for such family units. These patterned differences are addressed from a systemic perspective in five arenas: distance regulation and boundary maintenance, sexual expression, financial arrangements, breaking up, and stage differences in coming out and acceptance of lesbian identity.
PREDICTING MARITAL SUCCESS WITH PREPARE: A PREDICTIVE VALIDITY STUDY
Authors: Fowers Blaine J. , Olson David H.
Published: June 2007

In order to determine the predictive validity of the premarital inventory PREPARE, this study assessed the utility of PREPARE inpredicting marital success. A 3‐year follow‐up study was conducted with 164 couples who took PREPARE during their engagement. As hypothesized, it was found that satisfied couples scored significantly higher on the inventory than dissatisfied couples, divorced couples, and couples who cancelled their marriage. It was also hypothesized and found that dissatisfied married couples did not differ significantly from couples who cancelled their marriage or those who divorced. Using discriminant analysis, it was found that the PREPARE scores from 3 months before marriage could predict with 80–90% accuracy which couples were separated and divorced from those that were happily married. These findings not only demonstrate the predictive validity of PREPARE, but its potential utility in identifying high‐risk couples who could benefit from more intensive premarital counseling.
THE INTEGRATIVE PSYCHOTHERAPY ALLIANCE: FAMILY, COUPLE AND INDIVIDUAL THERAPY SCALES*
Authors: Pinsof William M. , Catherall Donald R.
Published: June 2007

The therapeutic alliance concept has been confined primarily to the literature on individual psychotherapy. This paper formally introduces the concept into the family and marital therapy domain and presents various clinical hypotheses about the nature of the alliance and its role in familyand marital therapy. A systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this integrative‐alliance concept for family, couple and individual therapy research are examined. Three new system‐ically oriented scales to measure the alliance in individual, couple and family therapy are presented along with some preliminary data on their methodological characteristics.
COMPONENT ANALYSIS OF BEHAVIORAL MARITAL THERAPY: 2‐YEAR FOLLOW‐UP AND PREDICTION OF RELAPSE
Authors: Jacobson Neil S. , Schmaling Karen B. , Holtzworth‐Munroe Amy
Published: June 2007

The present study provides 2‐year follow‐up data for a comparison between a complete behavioral marital therapy treatment package (CO) and two of its major components, behavior exchange (BE) andcommunication/problem‐solving training (CPT). Data are reported for 34 couples who were randomly assigned to one of these three treatments, completed the treatment to which they were assigned, and were available for the 2‐year follow‐up. The effects of therapy at the 2‐year follow‐up were evaluated using a global measure of marital satisfaction and a checklist of presenting marital problems. Statistically significant differences between the three treatments were not in evidence on any of the measures. However, couples in the CO treatment condition were most likely to be happily married and least likely to be separated or divorced. Attempts to identify variables which predicted long‐term outcome were largely unsuccessful. Ananalysis based on standardized telephone interview indicated that, while neither therapist attributes nor maintenance of treatment‐derived relationship skills were associated with long‐term marital satisfaction, stressful life events subsequent to therapy termination were negatively related to marital satisfaction.
ASSESSMENT OF INTERPERSONAL FUNCTIONS: DEVELOPING MEASURES TO AID THE FUNCTIONAL FAMILY THERAPIST
Authors: Roche Barbara A. , Moore Janet , Gordon Donald A.
Published: June 2007

One of the cornerstones of the functional family therapy model proposed by Alexander and Parsons (1982) is the assessment of interpersonal functions, which has traditionally been accomplished through intuition and clinical judgment. In this study, 109 college freshmen were recruited to evaluate the test‐retest reliability of a videotaped scenario measure and a questionnaire designed to assess interpersonal functions. Subjects responded to both measures during an initial assessment phase and then again, during a second assessment phase, 2 weeks later. Pearson product‐moment correlations and average agreement percentages indicate that both measures have adequate reliability. There were no sex differences, nor were subjects' responses related to a measure of social desirability.
THE “PSYCHOSOMATIC FAMILY” RECONSIDERED: DIABETES IN CONTEXT
Authors: Coyne James C. , Anderson Barbara J.
Published: June 2007

Minuchin, Rosman and Baker's (1978) Psychosomatic Families is widely cited as a demonstration that the physiological disturbance of some diabetic patients serves a function in their families. We found that the original data did not provide such a demonstration. We examined the psychosomatic family model in light of recent developments in the study and treatment of diabetes. We concluded that the model decontextualizes the family and assigns to it characteristics that are more appropriately seen as reflections of the disease process, the family coping tasks this entails, and the nature of the family's relationship with the health care system. The need for new open‐systems models of the family's role in diabetes is discussed.
FAMILY ASSESSMENT DEVICE: REPORTS FROM MOTHERS, FATHERS, AND ADOLESCENTS IN COMMUNITY AND CLINIC FAMILIES
Authors: Sawyer Michael G. , Sarris Aspasia , Baghurst Peter A. , Cross Darryl G. , Kalucy Ross S.
Published: June 2007

This study compared responses on the 60‐item version of the Family Assessment Device (FAD) obtained from mothers, fathers, and adolescents in two groups of families. The clinic group consisted of 94 families in which the adolescent had been referred to a mental health service in metropolitan Adelaide, South Australia. The community group consisted of 94 families, also containing an adolescent, living in the Adelaide community. Members of the clinic families consistently rated their families as less healthy than did families in the community. Importantly however, adolescents in both groups of families rated their families as significantly less healthy than their parents. Thus, while the results of the study provide support for the discriminative validity of the FAD, they also emphasize the need to consider separately self‐reports on family functioning obtained from different members of the same family.
ETHICS AND FAMILY THERAPY: THE CASE MANAGEMENT OF FAMILY VIOLENCE*
Authors: Willbach Daniel
Published: June 2007

All family therapists, and especially Milan‐style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.
MARRIAGE AND FAMILY THERAPISTS WORKING WITH FAMILY VIOLENCE: STRAINED BEDFELLOWS OR COMPATIBLE PARTNERS?: A COMMENTARY ON AVIS, KAUFMAN, AND BOGRAD
Authors: Meth Richard L.
Published: June 2007

Thelma is frustrated. She wants to go away for the weekend but approaching her husband with the idea seems impossible. Feeling annoyed, irritated, and trapped by her inability to discuss her plans, she yells at him instead. Responding in a tone that is both controlling and parental, he admonishes, “Didn't I tell you not to yell at me.” As if she had forgotten about her feelings and her needs, she meekly replies, “I'm sorry, I didn't want you to be late.” For those not familiar with the movie Thelma and Louise, Thelma does eventually summon up enough courage (with the support of her friend Louise) to leave, escaping from her chauvinistic and abusive husband on an exciting albeit brief adventure.
FAMILY SYSTEMS THERAPY IN A PRIMARY CARE MEDICAL SETTING: THE ROCHESTER EXPERIENCE
Authors: Seaburn David , Gawinski Barbara , Harp Jeff , McDaniel Susan , Waxman Dael , Shields Cleveland
Published: June 2007

Collaboration between family therapists and physicians has attracted increasing attention in the field of family therapy. Family therapists practicing in medical settings encounter many stimulating oppoutunities and challenges. This paper focuses on the experience of the authors providing family therapy in a primary care medical setting which is also a family medicine residency program. The authors discuss the role of physician and patient expectations in treatment as well as the influence of the medical context on the development of family therpists.
FAMILY CRISIS INTERVENTION BY PHONE: INTERVENTION WITH FAMILIES DURING THE GULF WAR
Authors: Shamai Michal
Published: June 2007

The purpose of this paper was to describe the ways in which a family therapy agency adjusted to emerging needs of families in Israel during the Gulf War. The therapeutic interventions were done by phone and followed a crisis intervention model. The impact of the special context arising from the war is described first, followed by a description of the problems related and the intervention provided. Finally, implications for family therapy are discussed.
UNDERSTANDING AND TREATING POST‐TRAUMATIC STRESS DISORDER SYMPTOMS IN FEMALE PARTNERS OF VETERANS WITH PTSD
Authors: Nelson Briana S. , Wright David W.
Published: June 2007

Studies of post‐traumatic stress disorder have focused primarily on veterans, generally ignoring their female partners (wives or girlfriends). recently, clinicians have begun to identify PTSD‐like symptoms in these female partners, but the literature describing this phenomenon has been limited. This paper addresses the fact that women in long‐term relationships with veterans suffering from PTSD commonly experience PTSD‐like psychiatric symptoms themseoves. These wonem's symptoms and issues they face in their relationships with their veteran partners are described. Conceptual explanations of and causal factors for these women's symptoms are presented, followed by discussion of treatment approaches and issues.
CREATING HEALING RELATIONSHIPS FOR COUPLES DEALING WITH TRAUMA: THE USE OF EMOTIONALLY FOCUSED MARITAL THERAPY
Authors: Johnson Susan M. , Williams‐Keeler Lyn
Published: June 2007

Emotionally focused marital therapy (EFT), a marital therapy that particularly focuses on the creation of secure attachment, has proven in empirical studies to be effective for distressed couples. This paper discusses the application of EFT in couples where one or both of the partners have experienced significant trauma. EFT, in this context of trauma, incorporates the nine steps of conventional EFT and also encompasses the three stages of the “constructivist” self development theory of trauma treatment. This paper illustrates how the integration of EFT and trauma treatement can prove effective in treating not only relationsip distress but also the individual symptoms of posttraumatic stress disorder (PTSD).
FAMILY THERAPY WITH INTELLECTUALLY AND CREATIVELY GIFTED CHILDREN
Authors: Moon Sidney M. , Hall Alex S.
Published: June 2007

Few family therapists have expertise in the psychology of giftedness, and little research has been conducted to determine the effectiveness of family therapy with talented children and their families. The purposes of this paper are: (1) to provide family therapists with information on the unique psychosocial stressors associated with giftedness and (2) to stimulate further research and development on the efficacy of family therapy in alleviating distress and actualizing potential in gifted and talented children and their families. The paper provides a critical overview of the existing research literature on gifted children and their families. First, current conceptualizations of giftedness are described. Then the research literature on the characteristics of intellectually and creatively gifted children and their families is reviewed with an emphasis on the endogenous (individual) and exogenous (systemic) factors that can create or exacerbate psychosocial problems. Finally, we suggest an eclectic, eco‐systemic approach to three common concerns that bring gifted children and their families to therapy.
ASSESSING CLIENTS' CONSTRUCTIONS OF THEIR PROBLEMS IN FAMILY THERAPY DISCOURSE
Authors: Friedlander Myrna L. , Heatherington Laurie
Published: June 2007

To study family members' narrative descriptions of their difficulties, we developed an observational coding system, the Cognitive Constructions Coding System (CCCS). In this system, 4 dimensions of clients' problem descriptions (intrapersonal‐interpersonal) and causal explanations (internal‐external, responsible‐not responsible, linear‐circular) are coded in the context of a Problem Elaboration Episode, a segment of psychotherapy discourse. In Studies 1 and 2 the reliability of the CCCS was assessed using transcripts from family therapy texts and interviews provided by 7 constructivist theorists. Across studies, mean interjudge agreements ranged from 56% to 98%; the mean reliability estimates were, however, more modest and variable (range .46 to .97). In Study 3, trained judges coded videotapes in which volunteers described personal problems that corresponded to specific CCCS codes. Results of this experiment showed that, on every dimension, the coding was more accurate than cahnce, all ps <.005. In Study 4, the CCCS successfully discriminated 6 of 8 family intake sessions in which the parents' descriptions of the presenting problem either did or did not shift from intrapersonal to interpersonal over the course of the interview. Directions for future research with the coding system are suggested, along with a discussion of its relevance for practice.
THE PARENTING EXPERIENCES OF MOTHERS WITH DISSOCIATIVE DISORDERS
Authors: Benjamin Lynn R. , Benjamin Robert , Rind Bruce
Published: June 2007

This article presents a qualitative analysis of the experience of parenting of mothers with dissociative disorders. This analysis was performed to complement the quantitative analysis of problems of mothers with dissociative disorders that Benjamin, Benjamin, and Rind (1996) presented previously. They found that the functioning of these mothers, as well as their subjective experience of mothering, was poorer that that of either clinical or nonclinical control mothers. Our goal was to provide a clearer, richer picture of their problems in parenting. Using the mothers' own words, we describe how the five symptom areas of dissociation (amnesia, depersonalization, derealization, identity confusion, and identity alteration) impeded their parenting efforts. We conclude with a discussion of the necessity of addressing parenting in the treatment of client‐mothers with dissociative disorders.
INFLUENCES ON THEf INCLUSION OF CHILDREN IN FAMILY THERAPY BRIEF REPORT
Authors: Johnson Laura , Thomas Volker
Published: June 2007

This study examined factors that influence family therapists to include children in or exclude them from therapy sessions. We hypothesized that therapist comfort, child problem type (internalizing vs. externalizing), family composition (one‐ vs two‐parent families), and presenting problem (child‐oriented problem vs. adult‐oriented problem) affect therapists' inclusion of children. A survey of clinical members of AAMFT found that half of the therapists excluded children on the basis of their comfort and that those who felt more comfortable were more likely to include children in sessions. Therapists included children more frequently in cases of an internalizing vs. an externalizing child, more with single‐parent than two‐ parent families, and more often when the presenting problem focused on a child than on an adult. Implications of the findings are discussed.
THE “COMING OF AGE” OF COUPLE THERAPY: A DECADE REVIEW
Authors: Johnson Susan , Lebow Jay
Published: June 2007

This article overviews significant developments in couple therapy over the last decade. Key trends include: (1) couple therapy becoming firmly established as the accepted treatment of choice for couple problems, (2) the blossoming of the science of relationships, (3) strong evidence supporting the effectiveness of couple therapy both for relationship problems and DSM disorders, (4) greater understanding of the ramifications of gender, (5) new respect for the diversity of family forms, (6) increased accent on the role of emotion, (7) the influence of postmodernism, (8) greater recognition of couple violence, and (9) the move toward integration across models of treatment.
THE INTERTWINED RELATIONSHIP BETWEEN DEPRESSION AND MARITAL DISTRESS: ELEMENTS OF MARITAL THERAPY CONDUCIVE TO EFFECTIVE TREATMENT OUTCOME
Authors: Kung Winnie W.
Published: June 2007

Within the framework of the interpersonal view of depression, this article examines the linkage between depression and fur aspects of marital relationship: stress, support, role expectations, and interactional dynamics. Acknowledging the interwined relationship between depression and marital adjustment, existing models of marital therapy for married depressed patients are examined for the extent to which they address these four aspects The empirical evidence for the efficacy of these models is also reviewed, suggesting elements of marital therapy that are conducive to effective treatment outcome.