Therapists entered the homes of 80 families in crisis and stayed for extended periods of time to prevent one or more family members from being placed in group homes, foster homes, or institutional care. Techniques used included crisis intervention, effectiveness training, assertion training, fair fight techniques, and behavior modification. Preliminary results indicated success in preventing outside placement for 121 out of 134 family members at a savings of over $2,300 per client, compared to projected cost of placement. Follow-up, which covered 16 months of service delivery, indicated that 97% of those avoiding placement continued to do so. Specific procedures used and possible reasons for success are discussed.When families become so disturbed that efforts of outpatient therapists, child welfare workers, probation officers, crisis clinic staff, and youth advocates all fail, removal of at least one family member to an institution or alternative living situation is the most common course of action. This occurs despite the fact that institutional care is extremely expensive and despite the knowledge that exposure to an institutional setting often leads to additional antisocial behavior and further self-deprecatory attitudes. When outside placement is necessary, family members remaining at home also suffer from feelings of loss, inadequacy, and hopelessness. Positive change as a clear result of removal of persons from the home occurs at high psychological, social, and monetary expense.It is likely that most mental health professionals and paraprofessionals make many of these referrals because they see no other way to prevent the situation from becoming worse. The present program is based on the

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Ballistocardiograms taken with the low frequency, critically damped ballistocardiograph on 17 patients having coaretation of the aorta have a characteristic pattern in which the K wave is absent. In the patients in whom the coarctation was surgically removed, the pattern returned toward the normal type with reappearance of the K wave.AtRECENT study by Nickerson' of the origin of the K wave of the ballistocardiogram has indicated that interference with the flow of blood down the descending aorta diminishes or eliminates this wave. The purpose of the present article is to report the ballistocardiographic findings in a series of patients with coarctation of the aorta and to demonstrate the changes in pattern appearing after surgical repair of the defect.The probability of the existence of a coaretation in all these patients was decided by clinical examination, and a ballistocardiogram under basal conditions was made. The ballistocardiograph used was the low-frequency, critically damped instrument designed by Nickerson and Curtis2 and tested by comparison with the direct Fick method by Nickerson, Warren, and Brannon.' Ballistocardiograms were also made postoperatively on those patients on whom operative procedures were undertaken. The first of these records was usually made about two weeks after operation and subsequent records were made when the patient returned to the hospital for examination. The records were made both with and without breath-holding,