HUGH ROSEN is professor and interim chairperson in the Department of Mental Health Sciences, School of Health Sciences and Humanities, at the Medical College of Pennsylvania and Hahnemann University. He is the author of Piagetian Dimensions of Clinical Relevance (1985) and the coeditor of Constructivist Perspectives on Developmental Psychopathology and Atypical Development (1991) with Daniel P. Keating. KEVIN T. KUEHLWEIN is a staff psychologist and clinical associate at the Center for Cognitive Therapy at the University of Pennsylvania. He served as the first clinical coordinator of the Beck