http://content.apa.org/journals/fsh Acting as a vehicle to express the voices of change in the healthcare system with a focus on family, the biopsychosocial model, and collaboration; and to participate in making those changes more humane for patients, families, and healthcare professionals.<BR><BR><i>Families, Systems, & Health</i> is a peer-reviewed, multidisciplinary journal that publishes clinical research, training, and theoretical contributions in the areas of families and health, with particular focus on collaborative family healthcare. en-us Copyright 2008 American Psychological Association Susan H. McDaniel, PhD; Thomas L. Campbell, MD 10917527 Mon, 17 Nov 2008 01:12:55 EST http://journals.apa.org/toc/journal/journal-fsh.jpg 77 http://content.apa.org/journals/fsh Business/Publishing and Printing/Publishing/Academic and Technical/Science Health/Mental Health Science/Social Sciences/Psychology/Journals and Publications http://blogs.law.harvard.edu/tech/rss http://content.apa.org/journals/fsh/26/3/237 http://content.apa.org/journals/fsh/26/3/237 Poor compliance with medication is a serious problem in chronic and terminal illness. Even though it carries a heavy toll of human suffering and a multibillion dollar price tag, noncompliance remains poorly understood. In this article, the authors narrate the experiences of a psychotherapist working in a state hospital and facing complexities of noncompliance in a serious childhood illness--thalassemia major. Interventions started at a time of iron overload at alarming and life threatening levels in a group of thalassemic patients. After six years of multilevel interventions with end-of-study patient follow-up, it was found that the patient group eventually reached the ideal treatment regimen. The compliance issue was addressed as one epiphenomenon of problematic interfaces between the thalassemia group and the provider system. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Marovic, Snezana; Snyders, Frederik American Psychological Association 10.1037/a0013054 http://content.apa.org/journals/fsh/26/3/250 http://content.apa.org/journals/fsh/26/3/250 General practitioners (GPs) in Australia typically do not refer clients to mental health care providers. Few systematic and referenced studies of the reasons for this lack of collaboration have been identified. The current research addresses this gap by investigating GPs' views on psychologists and the factors that determine patient referral. The research used a qualitative design consisting of semistructured in-depth interviews that were tape recorded, transcribed verbatim, and thematically analyzed. Participants were 12 Western Australian GPs from the Perth metropolitan area. The main findings were that GPs were satisfied with psychologists' capabilities but not their professional communications and were overwhelmingly dissatisfied with a mental health system that does not readily provide funding for patients in need of mental health care services. The findings suggest that GPs would like health care policies to be more inclusive of psychological services and are interested in collaborating with psychologists for better patient outcomes. Directions for further research are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Beel, Julianne Victoria; Gringart, Eyal; Edwards, Mary Ellen American Psychological Association 10.1037/a0012913 http://content.apa.org/journals/fsh/26/3/267 http://content.apa.org/journals/fsh/26/3/267 Coping with disability in the family is a multifaceted endeavor entailing changes in all spheres of life. Such changes affect not only the afflicted person but also the immediate relatives. The main objective of this study is to propose a comprehensive definitional framework for the quality of life concept, based on an action systemic approach to meet the challenge suggested in the literature. The work was focused mainly on examining the suitability of the systemic quality of life model for ascertaining life quality in family members coping with chronic illness in a relative. Ninety-four subjects in 47 families with a chronically ill or disabled relative were questioned formally. The model proved to be a valid and reliable instrument for this purpose, as well as affording us a picture of both the level and structure of the quality of life. Four significant differences were revealed in the four domains of the model: personal, physical, social, and cultural. The discussion interprets the level and structure of the subject's quality of life, and deals with its significance to the intervention process. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Feigin, Rena; Barnetz, Zion; Davidson-Arad, Barnetz American Psychological Association 10.1037/a0013055 http://content.apa.org/journals/fsh/26/3/282 http://content.apa.org/journals/fsh/26/3/282 The authors investigated whether uncertainty about the impact of children's chronic health conditions on their daily lives leads to changes in mothers' and fathers' mental and physical health. Three waves of data were collected over 3 years from parents of 228 children with chronic health conditions. Parents reported their level of uncertainty about how the child's health condition affected the child's daily life and measures of their own mental and physical health at each wave of data collection. Results of structural equation models indicate that among mothers, more illness-related uncertainty was associated with a subsequent increase in psychological symptoms relative to other mothers in the study. Psychological symptoms, in turn, were associated with a subsequent increase in physical symptoms among mothers. Uncertainty did not affect fathers' health. Illness-related uncertainty may be a risk factor for psychological and physical symptoms in mothers of children with chronic health conditions. As such, interventions that address uncertainty related to the child's chronic health condition may improve psychological and physical well-being of mothers of children with chronic health conditions. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Holm, Kristen E.; Patterson, Joan M.; Rueter, Martha A.; Wamboldt, Frederick American Psychological Association 10.1037/a0012912 http://content.apa.org/journals/fsh/26/3/296 http://content.apa.org/journals/fsh/26/3/296 BRCA1/2-positive women who learn their mutation status early in the life-course face unique challenges related to navigating the tasks of young adulthood. Using qualitative methods and grounded theory, the authors analyzed in-depth interviews with 11 women aged 26 to 35 who learned their mutation status before marriage. Their narratives illustrate the complexity of relationship formation, and highlight the potential for relationship-bonding and intimacy-building in the course of sharing mutation information. Disclosing BRCA mutation status to dating partners is often preceded by feelings of fear and anxiety, yet many participants reported that doing so has positive effects on relationships. Partners' abilities to respond with interest, empathy, and affection are associated with increased future intimacy, consistent with generally accepted principles within the family/couple systems field. Individual cancer risk perception and familial cancer experiences may affect the disclosure experience, which can be understood via Attachment Theory. Our findings provide clinical insight, identify new areas for research, and suggest ways to assist this unique population in their adjustment to being BRCA mutation-positive. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Hoskins, Lindsey M.; Roy, Kevin; Peters, June A.; Loud, Jennifer T.; Greene, Mark H. American Psychological Association 10.1037/a0012914 http://content.apa.org/journals/fsh/26/3/317 http://content.apa.org/journals/fsh/26/3/317 This essay explores the possibility of a generous medicine through discussion of L. Tolstoy's (1868/2005) War and Peace and Luke Fildes's painting "The Doctor." People confronting illness, like generals as depicted by Tolstoy, are never in control of events, yet they must take responsibility. The physician in Fildes's painting cannot control the course of his patient's disease, but he can, through the closest attention, perhaps deflect that course. The moral dilemma of humans, both healers and ill people, is to be both out of control and ultimately responsible. What we are most responsible for is sustaining generosity. The beginnings of generous medicine are some simple questions, with which the essay concludes. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Frank, Arthur W. American Psychological Association 10.1037/a0012915 http://content.apa.org/journals/fsh/26/3/328 http://content.apa.org/journals/fsh/26/3/328 Comments on the article titled Generous medicine by Arthur Frank (see record 2008-13279-006). The current author discusses Frank's idea of generous medicine while comparing it to other styles of narrative medicines. The author also discusses the importance of being a physician first when it comes to treating patients. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Goodrich, Thelma Jean American Psychological Association 10.1037/a0013183 http://content.apa.org/journals/fsh/26/3/333 http://content.apa.org/journals/fsh/26/3/333 Comments on the article titled Generous medicine by Arthur Frank (see record 2008-13279-006). In this issue of the journal, Arthur Frank offers a gift to clinicians who would be healers (Frank, 2008). Modern medicine has become such an unholy tangle of transactions, options, deals, requirements, negotiations, mandates, demands, and pressures that from time to time we lose our way. Dr. Frank reaches into this tangle for a first principle on which our usefulness as healers can be organized, and he pulls out, like a bright red thread running through it all, generosity. This generosity, however, is neither simple nor straightforward. It starts with the humility of seeing our place as a small vector among many large and longstanding forces that bear on another person's life and health. We may influence but we do not control, and the sooner one releases the delusion of control, as does Tolstoy's General Kutozov, the better. The current author is so in tune with and inspired by this formulation that he is tempted to let it stand in its own light, but just as Frank accepted the gifts of Tolstoy and Fildes, and used them, together with his own talents and efforts and experience in our field of medicine to make something new and meaningful for us, so are we obligated to accept this idea of generous medicine and make something new with it. The current author proposes to first consider a little more closely the notion of listening to and participating in a patient's narrative, and then probe for how to actually accomplish this as a clinician today. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 deGruy III, Frank American Psychological Association 10.1037/a0013189 http://content.apa.org/journals/fsh/26/3/336 http://content.apa.org/journals/fsh/26/3/336 This article is a personal narrative of the author about his experience and life in relation to Mark. Mark is the brother of Maeve, the author's wife, who committed suicide when he was 20. This article shows the reflection of the author on his life not knowing Mark, but knowing of Mark. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Schultz, Stephen American Psychological Association 10.1037/a0013058 http://content.apa.org/journals/fsh/26/3/341 http://content.apa.org/journals/fsh/26/3/341 In this section, the book review editor reflects on his experience editing the Book Review section of Families Systems and Health. He concludes this section with the announcement of his retirement. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Waters, David B. American Psychological Association 10.1037/a0001183 http://content.apa.org/journals/fsh/26/3/342 http://content.apa.org/journals/fsh/26/3/342 Reviews the book, Immigrant families in contemporary society edited by Jennifer E. Lansford, Kirby Deater-Deckard, and Marc H. Bornstein (see record 2007-11856-000). This book is a timely and useful addition to the literature on the health and development of immigrant children and families. As the fifth volume in the Duke Series in Child Development and Public Policy, its stated purpose is to synthesize cutting edge research and theory on child development in order to bring to bear public policy and other solutions to problems facing children and families in contemporary society. The volume results from the papers presented at a conference with nationally renowned scholars in the fields of sociology, social work, anthropology, public policy, medicine, economics, family studies, and others. This interdisciplinary approach makes this book a valuable reference for all of these disciplines, as well as other individuals who work with immigrants and refugees. While being thoughtful and well-researched, the language and style of the contributions will be accessible and understandable to readers from academia to front line practitioners. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Hauck, Fern R. American Psychological Association 10.1037/a0013184 http://content.apa.org/journals/fsh/26/3/344 http://content.apa.org/journals/fsh/26/3/344 Reviews the book, Attachment theory in clinical work with children edited by David Oppenheim and Douglas F. Goldsmith (see record 2007-05957-000). This book is the culmination of over 15 years of development and collaboration by a great many people actively involved in both research and the clinical application of attachment theory. The book is divided into two parts. Part one applies research-based assessments of attachment to a clinical population. Each chapter in Part one includes a description of the assessment tool used, an explanation of its design and implementation in a research setting and then a description of its use in a clinical setting. Part 2 is concerned with attachment theory and psychotherapy. The focus in this section is more on treatment and the integration of psychotherapeutic principles and treatment modalities as specifically applied to the issues surrounding attachment problems. This is a book that is useful both for the academic study of clinical perspectives on attachment and is also a wonderful opening to the clinical value of finding pathways to healing for children and adults who suffer with inadequate attachment to secure relationships in their lives. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Lyle, Randall R. American Psychological Association 10.1037/a0013185 http://content.apa.org/journals/fsh/26/3/345 http://content.apa.org/journals/fsh/26/3/345 Reviews the book, STOP domestic violence: Innovated skills, techniques, options, and plans for better relationships--Group leader's manual by David B. Wexler (see record 2007-00540-000) The issue of domestic violence has been gaining attention globally despite the reluctance of some cultures to acknowledge it as a problem to be addressed. David B. Wexler's Domestic violence 2000 was a boon to this area of study as it offered practical materials for therapists and counselors to use in their work with the heterosexual men who commit acts of violence against their "significant other". His newest book is a well thought-out, efficiently organized and "layman-friendly" work recapitulating some of the themes of his aforementioned book, while incorporating material based on the plethora of new research and models in this field. This resource is strongly recommended for any therapist, counselor or social worker committed to helping abusive men break the cycle of abuse in their homes. With its easy-to-follow structure, Wexler's manual presents as a workbook and a guide by which discussion group leaders may direct and organize their sessions with men who commit acts of domestic violence. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Robinson, Tyra American Psychological Association 10.1037/a0013187 http://content.apa.org/journals/fsh/26/3/348 http://content.apa.org/journals/fsh/26/3/348 This narrative discusses the author's 5 year journey with a patient named Helen. His relationship with this patient helped him to relearn a core principle of helping relationships: the value of "being with" rather than "doing to." There is intrinsic value walking alongside another without trying to guide; to be a "learner" rather than a "knower." Helen was looking for a caddy to walk by her side and offer her an opinion of the terrain ahead rather than a pro to correct her swing. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Marvel, Kim American Psychological Association 10.1037/a0013057 http://content.apa.org/journals/fsh/26/3/350 http://content.apa.org/journals/fsh/26/3/350 As the subdiscipline of medical family therapy grows, collaborative partnerships between family therapy programs and HIV/AIDS clinics represent a promising opportunity to systemically address the medical, intrapersonal, and interpersonal issues that often arise when a family member is coping with the diagnosis and treatment of HIV/AIDS. This article highlights a successful collaboration between Drexel's Couple and Family Therapy Program and a Pediatric and Adolescent HIV/AIDS clinic at St. Christopher's Hospital for Children. The authors describe a brief history of St. Christopher's Pediatric and Adolescent HIV/AIDS clinic and its transition from a more traditional nonfamily therapy model to one that is systemic. An illustrative case example and lessons learned about developing successful collaborations with HIV/AIDS clinics are presented. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Davey, Maureen P.; Duncan, Tracey M.; Foster, Jill; Milton, Katrina American Psychological Association 10.1037/a0013056 http://content.apa.org/journals/fsh/26/3/356 http://content.apa.org/journals/fsh/26/3/356 This article describes a residency educational process that considers the reciprocal impact doctors and patients have on each other, using a modified "MegaClinic" conference model. Specific description of the 1-hr, once-a-month interdisciplinary conference is provided, including preparation, examples of discussion content, and facilitator considerations. The MegaClinic considers how a physician, in the context of the entire office system, interacts with and is influenced by a succession of patients who are coincidentally scheduled during the same patient-care session. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Sternlieb, Jeffrey L. American Psychological Association 10.1037/a0013059 http://content.apa.org/journals/fsh/26/3/365 http://content.apa.org/journals/fsh/26/3/365 This article discusses the case of Jonas, a father and a working man who had psychiatric issues, and and his wife Audrey. Originally the case discusses the family's primary care practice and their collaboration to help Jonas' psychiatric issues. Once the couple's baby boy Aiden was born, the focus shifted to his physical development. The case focused on collaborative interventions in the family's primary care practice to help bring Aiden out of his failure to thrive path. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Rosenberg, Tziporah; Brown, Elizabeth; Gawinski, Barbara American Psychological Association 10.1037/a0013333 http://content.apa.org/journals/fsh/26/3/372 http://content.apa.org/journals/fsh/26/3/372 The current author and his colleagues have been trying, somewhat unsuccessfully as indicated by the title of this Casebook presentation, to change the terminology from the more historically accepted "Failure to Thrive" to the more clinically accurate "Pediatric Undernutrition" (Kessler, 1999). Nevertheless, the current case highlights the importance of reformulating this clinical syndrome away from a unitary biomedical perspective to one that simultaneously considers child and family life circumstances and mental health needs as suggested by Dr. George L. Engel, from the University of Rochester. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Families, Systems, & Health - Vol 26, Iss 3 2008 Kessler, Daniel B. American Psychological Association 10.1037/a0013188