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