Few topics rouse the passions of parents, educators and those who work in early childhood, as the value of television watching in this youngest age group. Zimmerman et al (2007) has taken the bull by the horns (or the television by its aerial) and directly addressed the question of the association between media exposure and language development in children under two years. As these authors note, “several high-quality educational television shows have proven educational value when viewed appropriately by children age 2-1/2 to 5 years. However, while the American Academy of Paediatrics has recommended no screen time for those under 2, those selling DVD’s for this age group make explicit and specific claims as to their educational benefits.
Data was collected via a television survey in 2006 in the states of Washington and Minnesota in the United States of America. with 1,008 subjects participating. Caregivers were asked a series of detailed questions about how the child spent their time, including that spent interacting with adults in a number of categories and time and type of television viewing. Demographic data about numbers in the household, the presence of siblings, maternal and paternal education, family income, ethnicity, race and care arrangements was also collected. Parents also completed the short form of the MacArthur-Bates Communicative Development Inventory, a device for measuring children’s language development.
The results were clear, revealing a large negative association between viewing of baby DVD’s/videos and vocabulary acquisition in children aged 8 to 16 months. While the authors postulate a number of interesting hypotheses as to why this should be so, and clearly state that the study did not test, through experimental manipulation, whether such viewing had a positive or negative impact on vocabulary acquisition, it is ‘a compelling place to start’. The authors propose the need for a large-scale randomized controlled trial where some families actively discourage their babies television watching. Until we can see these results, it can only make one think twice before reaching for the remote control baby sitter.
Zimmerman,F.J.,Christakis,D.A.& Meltzoff,A.N.(2007) “Association Between Media Viewing and Language Development in Children Under 2 Years” The Journal of Pediatrics, October pp364-368
In preparing for Maurizio Andolfi’s visit to Adelaide in late March, I was fascinated to encounter his view of the recent fate of family therapy. The very last paragraph of his paper, “A 35 Year Long Personal - Professional Journey”, a work in preparation for possible publication in the Australian and New Zealand Journal of Family Therapy, is entitled “Why Family Therapy Lost its Mission in Social Community Realities?” In the 70’s and 80’s he contends, family therapy developed as a search for “concrete resources and answers in social contexts” which were directly connected to “people’s problems and realities”. For Andolfi, this is not an abstraction for in the early 1970’s as a resident in New York City and Fellow in Social and Community Psychiatry at the Albert Einstein College of Medicine, he worked in the South Bronx with highly disadvantaged families from diverse ethnic groups. This experience was reinforced by his work in South Philadelphia with Salvador Minuchin and Jay Haley. He goes on to suggest that the appropriation of family therapy by tertiary institutions and mental health agencies cost its “marginal perspective” and delivered a place in the mainstream. It has also negated “the pioneering spirit and capacity to speak out against the psychiatric establishment and the institutional bureaucracy”. These changes are reinforced by what he perceives to be an “increased individualism” and resultant consumerism of the last decades. These changes have impacted on therapy which has adapted its interventions from “social and community tools” to “became mostly a service for individual wealthy and lonely clients” and less accessible and used by families.
What also flows from these changes is “an increase in conformist ideas and language” and the development of theories and models “where real people are missing”. Its time, he suggests, to return to “simple, concrete language in order to embrace everyone instead of using complex and abstract concepts with very impressive labels”.
How could anyone disagree, but do we really want to open up the gates, to back away from our increasing passion for accreditation, specialized vocabularies and sanitized practice? You never know who might want to join!
Still going strong after 35 years must be an achievement in any occupation but to be ‘alive and kicking’ as a therapist is surely impressive. Maurizio Andolfi, Full Professor in the Department of Psychology at the University of Rome who trained as a child psychiatrist in Rome and at the Ackerman Family Institute and Philadelphia Child Guidance Clinic in America, can make just such a claim. And you just have to ask “How does he do it?”The answer may lie in his recent paper, prepared for possible publication in the Australian and New Zealand Journal of Family Therapy, “A 35 Year Long Personal - Professional Journey”. In this he elucidates his intergenerational approach to marital therapy with its emphasis on actively including both family of origin, parents and siblings, and children in the presence of each spouse. He regards the generations on either side of the troubled couple as a valuable resource, the previous generation available to help discover new relational pathways and children to ‘enhance information gathering, creativity, flexibility and playfulness”.
But wait, there is more. Andolfi has also presided over a thirteen year outcome research project into the evaluation of family therapy treatments. This has involved one hundred and fifty families and explored outcomes in three situations; where therapy last less than three sessions, where therapy concludes after several sessions without a satisfactory conclusion and where therapy concludes with a positive outcome.
There are also the “International Practicum” he has held in Rome from 1981 to 2006 and his own world travels which have kept the elixir alive. Working with seasoned therapist, the Rome experience encourages practitioners to identify their own “professional handicap’ or charecterological limitation to their work. In identifying and addressing this, the trainee is encouraged to explore and discover new ways of using themselves.
Finally, and in Andolfi’s own words there is his history of “cultural marginality”. “I learned how to stay at the edge of the scientific discourse without needing to follow the mainstream mode of rules and models, without giving up to common sense and to the “lessons of the road”, the knowledge which comes from real people in their social contexts and not only academic knowledge ex cathedra.”
Nothing is a exhilarating as working with a couple whose distress has brought them to the point of despair and annihilation of the relationship and feeling instrumental in its recovery. Equally the pain of encountering the impossibility of influencing the course of events and presiding over the demise of a relationship is equally compelling. Our experience of our own efficacy is highly subjective and it is important to look to the literature of outcome studies to satisfactorily address the question “Does it work?”
As late as (1998) Werry was sadly reflecting that “family therapy has many of the hall marks of a religion with several competing sects led by feuding charismatic prophets each claiming to have a premium on the truth, but with few of the attributes of a profession rooted in ethics and skepticism”. However by 2003 Sprenkle (2003) was able to say that in reviewing the literature “Werry’s blanket indictment of the field is no longer valid”. Johnson and Lebow (2000) cited research studies which pointed to the efficacy of both Behavioral Marital Therapy and Emotionally Focused Therapy. While the former produced an effect size of .95, meaning those who undertook this treatment had higher scores on outcome measures than 83% of treated couples; questions remained as to the long term benefits of the approach. By contrast Emotionally Focused Therapy, which is based on attachment theory, produced an effect size of 1.3 with no evidence of relapse at two year follow-up. When the two approaches were compared EFT was more effective than behavioral exchange and skill building interventions. By 2005 Stratton, writing for the Association of Family Therapy in Britain concluded that while the efficacy research is ‘generally positive’ there remains a need to replicate treatments shown to be effective by specialists who are often the originators of an approach in more realistic field conditions. This challenge is been met. Wright et.al 2007 paper. “The Clinical Representativeness of Couple Therapy Outcome Research reported that where pretherapy training was less intensive, treatment less structured and therapists more experienced larger effect size was noted.
So, it seems we can say ‘Yes’ to our original question. However there are as many questions generated as are answered and perhaps it is time we all began to consider our contribution to providing answers to these new and provocative questions.
Johnson ,S & Lebow,J.(2000) The “Coming of Age” of Couple Therapy:A Decade Review Journal of Marital and Family Therapy Vol 26:23-38
Sprenkle,D.H.(2003)Effectiveness Research in Marriage and Family Therapy:Introduction Journal of Marital and Family Therapy Vol 29:85-96
Stratton,P. (2005) Report On The Evidence Base of Systemic Family Therapy Association for Family Therapy
Werry,J.S. (1989) Family Therapy: Professional Endeavor or Successful Religion? Journal of Family Therapy,11:377-382
Wright,J. et al (2007) The Clinical Representativeness of Couple Therapy Outcome Research Family Process 46:301-316
0, my love is like a red, red rose,
that’s newly sprung in June.
0, my love is like a melody,
that’s sweetly play’d in tune.
As fair thou art, my bonnie lass,
so deep in love am I,
And I will love thee still, my dear,
till a’ the seas gang dry.
If you don’t recognize Robert Burns famous love poem you will surely recognize the sentiment; the madness we call love where the beloved is close to perfection and for that space in time we can guarantee that it will be forever. How do we explain this and does it advantage us or merely set us up for disappointment?
Cindy Hazen (2003) in her paper “The Essential Nature of the Couple Relationship” suggests that an attachment perspective may provide the answer. She notes the four key features of attachment; the seeking and maintaining of physical proximity, seeking aid or comfort, being distressed by prolonged separation and using the attachment figure as a secure base for engaging in non-attachment activities are, in adulthood, directed towards a mate. However an effective emotional bond takes approximately two years to form, give or take six months and a mechanism is required which will produce a single-minded attention on the other, is equally powerful in men and women and which produces a strong desire for physical contact which fosters attachment. Infatuation of ‘falling in love’ seems to achieve all these ends. In a study of romantic infatuation, Tennov (1979) found respondents reported a decrease in sleep and appetite with an increase in energy, mental preoccupation, idealization of the beloved and intense longing for physical contact. Some authors have hypothesized that these effects are mediated by phenylethylamine, an endogenous amphetamine with mildly hallucinogenic effect. This drug dramatically alters social perception making us see our partners as significantly more attractive than others do.
How long does it take the ’drug’ of romantic infatuation to wear off? On average two years, just long enough for us to bond!
Hazen, C (2003) “The Essential Nature of the Couple Relationship” in Johnson, S & Whiffen, V. Attachment Processes in Couple and Family Therapy (2003) The Guilford Press
