Evidence converges from a wide range of contexts to suggest that the causal beliefs held by an individual, or predominant in a group of individuals, are of considerable practical significance and theoretical interest. A good system for analysing naturally occurring expressions of causal belief would provide the possibility of testing and exploring this supposition without having to rely on possibly artificial questionnaire responses. A rationale for such a system is described and a study of the reliability of the coding procedure is reported. It has proved possible to formulate definitions of the five major dimensions identified in the attribution literature so that, while they are not all orthogonal, each provides unique information. The coding system is shown to have adequate reliability, and to generate substantial quantities of data. The findings from these data are generally in accordance with those obtained using more traditional methodologies, and provide substantive information about the subject population. The method is proposed as an effective technique for empirical investigations of the forms, stability and significance of naturally expressed causal beliefs.
Working with families, especially in areas such as child abuse, throws up many situations that can be viewed as crises requiring urgent action. The sense of urgency can increase when attempts to protect children are met with denial and obstruction. In reviewing our experiences over more than 30 years we have come to recognize that being organized by this sense of crisis can be counterproductive. An alternative has been the counterintuitive reaction of slowing down the process and valuing the chance to consider alternatives while maintaining a steady perseverance. In other words, of patience. We consider the influences, especially from systemic therapy and attachment research that have helped us deal patiently with denial and the potentially frustrating behaviour of abused children that is an outcome of their adaptations to prolonged maltreatment. The article concludes by proposing the value of patience as a useful stance in relation to current developments in family therapy.
Summary
Failure to thrive is a complex problem affecting long‐term health and development of the child. This paper describes a multidisciplinary approach to management and treatment of children and families where there is a child who is failing to thrive. The experience described in this paper is based on many years work of an interdisciplinary nature involving a Paediatrician, Psychologist and Dietician which lead to the creation of a special clinic for these children in 1993.
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