abstracts

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ABSTRACTS Behavioral science and family practice: A status report Hornsby JL, Kerr RM. J Fam Pracl 8:299- 304, 1979. Since 1969, family practice resi- dency training programs have pro- liferated rapidly. Both the Ameri- can Academy of Family Physicians and the Department of Graduate Medical Education of the AMA refer to the inclusion of behavioral science as essential to a family practice residency training pro- gram. However, guidelines regard- ing this behavioral science compo- nent remain broad. Some programs include almost no behavioral science, whereas others have an abundance. The purpose of this study was to assess: (I) the charac- teristics of those who teach behav- ioral science, (2) the relative im- portance of various behavioral science topics as perceived by fac- ulty/staff, and (3) preferred methods of behavioral science in- struction. A questionnaire that ex- plored these areas was sent to 286 accredited family practice pro- grams in the United States. The study covered 136 returned, com- pleted questionnaires. Of those persons teaching behavioral science, 46% were physicians and 54% were nOI1physicians. Of the physicians, 67% were psychiatrists, and 27% were family physicians. The majority of the nonphysicians were psychologists. Most depart- ments surveyed employed from one to three persons who taught behav- ioral science. Only 13 departments employed no one to teach behav- ioral science. As to percentage of time that persons teaching behav- 724 ioral science devoted to family practice, most persons were thus employed in the I% to 25% and 76% to 100% ranges. Most part-time persons were shared with depart- ments of psychiatry. The people teaching behavioral science had multiple responsibilities, with the majority involved in patient care. Family practice departments were responsible for teaching behavioral science in 45% of the programs, while psychiatry departments were responsible in 26%. Interviewing skills, family and individual coun- seling, and psychosocial growth and development were among the major topics that were taught Pe- dagogic techniques most used ",ere consultations, lectures, and semi- nars. Thus, the data revealed a wide variety of persons involved in be- havioral science instruction, a strong emphasis placed on commu- nication and counseling skills, and several not particularly innovative teaching methods used for behav- ioral science instruction. Richard L. Goldberg, M.D. Georgetown University Paul Schilder and group psychotherapy: The development of psychoanalytic group psychotherapy Pinney EL Jr. Psychiatric Quart 50: 133-143. 1978. Paul Schilder is best known for his work concerning body image and the emotional constructs of the "body ego." He was germinal, however, in the development of group psychotherapy. Historically, the modern originator of group therapy has been thought to be Dr. Joseph Pratt, who utilized the model of a Sunday school class in assembling tuberculous patients and discussing their disease. Pratt specifically rejected Freudian ideas about psychic causality. Pratt's fol- lowers developed group settings for the treatment of individuals with psychiatric illnesses; but these meetings turned more towards ed- ucational and moral inspiration than towards understanding of be- havior. In 1928 Trigant Burrow de- veloped a group treatment in which he made certain interpretations to an individual within a group. Schilder presented his experience with group treatment in 1936. He attempted to gather biographic data from his patients within the group setting. He felt this helped him to make interpretations as well as allowing some group cohesive- ness to develop. He also was one of the early observers of group phe- nomena, in contradistinction to group analysis. Schilder noted that there was a "social determination" within the group setting. He uti- lized transference phenomena and interpretations within his group a pproaches. In his position as Director of Research at the Belle- vue Psychiatric Hospital, Schilder utilized therapeutic groups. He felt that this treatment gave a patient further iI1sight into his individual difficulties and allowed him to cope in a more adequate fashion. Al- though Schilder receives little rec- ognition in current texts on group psychotherapy, it appears that his work anticipated much of what fol- lowed in the development of this form of therapy. Thomas N. Wise, M.D. Falls Church, Va. PSYCHOSOMATICS

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Page 1: Abstracts

ABSTRACTS

Behavioral science andfamily practice: A statusreportHornsby JL, Kerr RM. J Fam Pracl 8:299­304, 1979.

• Since 1969, family practice resi­dency training programs have pro­liferated rapidly. Both the Ameri­can Academy of Family Physiciansand the Department of GraduateMedical Education of the AMArefer to the inclusion ofbehavioralscience as essential to a familypractice residency training pro­gram. However, guidelines regard­ing this behavioral science compo­nent remain broad. Some programsinclude almost no behavioralscience, whereas others have anabundance. The purpose of thisstudy was to assess: (I) the charac­teristics of those who teach behav­ioral science, (2) the relative im­portance of various behavioralscience topics as perceived by fac­ulty/staff, and (3) preferredmethods of behavioral science in­struction. A questionnaire that ex­plored these areas was sent to 286accredited family practice pro­grams in the United States. Thestudy covered 136 returned, com­pleted questionnaires. Of thosepersons teaching behavioralscience, 46% were physicians and54% were nOI1physicians. Of thephysicians, 67% were psychiatrists,and 27% were family physicians.The majority of the nonphysicianswere psychologists. Most depart­ments surveyed employed from oneto three persons who taught behav­ioral science. Only 13 departmentsemployed no one to teach behav­ioral science. As to percentage oftime that persons teaching behav-

724

ioral science devoted to familypractice, most persons were thusemployed in the I% to 25% and 76%to 100% ranges. Most part-timepersons were shared with depart­ments of psychiatry. The peopleteaching behavioral science hadmultiple responsibilities, with themajority involved in patient care.Family practice departments wereresponsible for teaching behavioralscience in 45% of the programs,while psychiatry departments wereresponsible in 26%. Interviewingskills, family and individual coun­seling, and psychosocial growthand development were among themajor topics that were taught Pe­dagogic techniques most used ",ereconsultations, lectures, and semi­nars. Thus, the data revealed a widevariety of persons involved in be­havioral science instruction, astrong emphasis placed on commu­nication and counseling skills, andseveral not particularly innovativeteaching methods used for behav­ioral science instruction.

Richard L. Goldberg, M.D.Georgetown University

Paul Schilder and grouppsychotherapy: Thedevelopment ofpsychoanalytic grouppsychotherapyPinney EL Jr. Psychiatric Quart 50: 133-143.1978.

• Paul Schilder is best known forhis work concerning body imageand the emotional constructs of the"body ego." He was germinal,however, in the development ofgrou p psychotherapy. Historically,the modern originator of grouptherapy has been thought to be Dr.

Joseph Pratt, who utilized themodel of a Sunday school class inassembling tuberculous patientsand discussing their disease. Prattspecifically rejected Freudian ideasabout psychic causality. Pratt's fol­lowers developed group settings forthe treatment of individuals withpsychiatric illnesses; but thesemeetings turned more towards ed­ucational and moral inspirationthan towards understanding of be­havior. In 1928 Trigant Burrow de­veloped a group treatment in whichhe made certain interpretations toan individual within a group.Schilder presented his experiencewith group treatment in 1936. Heattempted to gather biographicdata from his patients within thegroup setting. He felt this helpedhim to make interpretations as wellas allowing some group cohesive­ness to develop. He also was one ofthe early observers of group phe­nomena, in contradistinction togroup analysis. Schilder noted thatthere was a "social determination"within the group setting. He uti­lized transference phenomena andinterpretations within his groupa pproaches. In his position asDirector of Research at the Belle­vue Psychiatric Hospital, Schilderutilized therapeutic groups. He feltthat this treatment gave a patientfurther iI1sight into his individualdifficulties and allowed him to copein a more adequate fashion. Al­though Schilder receives little rec­ognition in current texts on grouppsychotherapy, it appears that hiswork anticipated much of what fol­lowed in the development of thisform of therapy.

Thomas N. Wise, M.D.Falls Church, Va.

PSYCHOSOMATICS