Family experiences of self-mutilating patients.
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Biomedical subjects
Publications and source records attributed to S I Abramowitz.
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We attempted to extend two findings obtained at private university clinics to a heterogeneous community outpatient population: an under-representation of male patients in the case loads of beginning female therapists and longer treatment of female patients by beginning male therapists. Data from professional and preprofessional psychiatrists, psychologists, and social workers partially replicated the first finding but not the second. The results thus leave open the question of subtle sex role-related countertransference in a large urban community mental health setting.
Investigated the effects of offering clients (N = 55) a choice of therapeutic style on show rate and reactions to the initial interview. Individuals who called for an appointment were assigned randomly to Choice and Attention-Control conditions. Choice Ss were informed that they would be assigned to a therapist who identified with one of two descriptions of therapy styles from which they could choose. Based on this choice, these persons were scheduled with the next therapist in line who had identified him/herself with the selected style. Attention-Control clients were informed about the range of services available at the clinic and paired with a therapist regardless of style on the usual rotating basis. A significantly higher proportion of Choice than Attention-Control Ss kept their schedules appointments. However, no significant differences were found on client and therapist evaluations of the initial interview.
Recontacted 17 Ss who had undergone successful imaginal or in vivo desensitization for snake phobia and had been evaluated pre- and posttreatment for a 9-month follow-up. Main findings were that: (a) overall treatment gains were maintained through the follow-up period; (b) differential gains in favor of the in vivo technique on one behavioral and two self-report snake-specific criteria were dissipated; and (c) imaginal Ss registered a reduction in self-rated fear during an approach task from posttesting to follow-up. Results are discussed in relation to the notion of cognitive rehearsal as a means of self-reinforcing treatment gains.
The predictive utility of patient flexibility as a moderator of persistence and benefit from sex therapy was examined. In addition to a direct self-report flexibility scale, 21 couples completed psychometric measures of sexual and marital compatibility before undergoing a modified Masters and Johnson sexual retraining regimen. Following treatment the 15 continuing pairs filled out the same satisfaction inventories and, along with their male and female cotherapists, made posttherapy ratings of change on sex-specific personal and marital criteria. Flexibility proved to be a strikingly effective discriminator of remainers from early terminators and demonstrated promise as a predictor of favorable sex therapy outcome. Results are discussed in terms of the need to identify and prepare rigid individuals who cannot easily accommodate the relatively directive and value-laden features of sexual retraining.
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The relationship between insight and adjustment in schizophrenics was examined. Subjects who scored higher on a paper-and-pencil insight test were rated by hospital staff as better adjusted behaviourally but described themselves as more psychologically distressed than presumably less insightful subjects. Results were discussed in relation to the notion that insight in schizophrenics may intensify subjective distress while conducing to behavioural adaptation.
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Data from one psychological and one psychiatric agency were collected to determine if psychotherapists' treatment decisions about opposite-sex persons might be influenced by sex-role prescriptions for dealing with sexual impulses. Accordingly, male therapists were hypothesized to prolong and female therapists to avoid treatment situations likely to arouse their sexual curiosities. The results at both facilities provide some support for these notions and, if generalizable, establish sex-role primed countertransference as a factor in patient selection and termination.
A serendipitous finding and a replication among successive populations of clinical-counseling practicum students suggest that the typical female therapist communicates more empathically than her male colleague. In the first study, reactions of 8 women trainees were evaluated as more empathic than those of 10 men counterparts. Despite control for sex-typed handwriting cues in the second study, 8 male novitiates' responses were assessed as less empathic than those of 8 females. The results are consistent with the notion of differential sex-role prescriptions for interpersonal sensitivity.
Health-care-related professionals rated the appropriateness and preferred timing of various community intervention strategies for assisting the bereaved individual. Results indicated: (a) agreement about the general need for such assistance programs, but no concensus as to which were most appropriate; (b) endorsement of the "resumption of activity" ethic; (c) belief that the most desirable period in which to intervene is within six months from the death; and (d) the lesser perceived suitability of therapeutic modalities that involve social contact with nonfamily members immediately following the death. Earlier introduction of family therapy and multiple family counseling was advocated by respondents with greater experience treating the bereaved.
The impact of patients' and family therapists' own family values on judgments about a help-seeking family was investigated via a clinical analogue. Fifty family-oriented clinicians were classified as either traditional or nontraditional in their beliefs about the family. Clinical judgments were rendered of a hypothetical family in which the parents' verbalizations were suggestive of either traditional or nontraditional family values. Little diagnostic value-bias was detected, thereby failing to establish the operation of political bias in the family treatment setting.
This study was done to determine the impact of patient racial attribution on black practitioners' clinical judgments. Fifty-five professionals indicated their clinical reactions to a bogus case description of a sexually maladjusted male patient identified as black or white and also completed a traditional social beliefs scale. Relatively untraditional clinicians evaluated the black-designated patient more favorably than the white-designated patient. The less traditional practitioners also evaluated the black-designated patient more favorably than did the traditional clinicians. Effects of patient race were found for both clinical impressions and treatment decisions and were not attenuated in the more highly experienced subsample. Implications and limitations of the findings are discussed.
An attempt was made to reproduce and extend previously reported data suggesting the operation of sex-related bias in clinicians' attributions of parental involvement in children's psychopathologies. More and less sex-role traditional male and female family-oriented practitioners were shown contrived profiles in which a boy or girl was described as masculine or feminine role-deficient, and apportioned maternal versus paternal blame, treatment focus, adjunctive therapy need, and likelihood of sabotage. As in the previous study, mothers were implicated slightly more than fathers and also were viewed as requiring relatively greater therapeutic attention by female than by male clinicians. However, several earlier findings were not replicated. Overall, the results offer only marginal support for the notion of sex-related practitioner bias.
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