When a family member has an intellectual handicap

Oral histories of ten close relatives of people over the age of 50 defined as intellectually handicapped have been collected as part of the New Zealand Ageing and Intellectual Handicap study. Many of the individuals with intellectual handicap were institutionalized from an early age; some had little or no contact with family members for a very long time; others lived continuously at home. The qualitative data record over 50 years' experience of having a family member with intellectual handicap, from early childhood through to middle or old age, and outline concerns about deinstitutionalisation and the future. It is concluded that families cannot go it alone and that the full participation of people with disabilities in community life and culture depends on well-resourced public policies and programmes of inclusion.     

When Opportunity is the Thing to be Equalised

This paper discusses the goal set out by the United Nations in its Standard Rules on the Equalisation of Opportunities for Persons with Disabilities. The objective 'equalisation of opportunities' means both to render unlawful discrimination against persons with disabilities in every area of society, and to eliminate those very discriminatory conditions in society which render real participation impossible. The two conflicting approaches to handicap, the individual-centred and the person-environment approach, are both visible in the Standard Rules. This article suggests that the individual-centred approach is structurally related with the understanding of equal treatment as a relationship with formal characteristics, no matter what the setting in which it occurs, while the person-environment approach is related with an active social policy emerging from an understanding of equal treatment as a question of substantial right. There is thus a conflict inherent in the Standard Rules.     

Meeting spiritual needs on an inpatient unit

Two focus groups were held with patients who had experienced inpatient hospitalization and their families, to discuss spiritual needs during psychosis. Spirituality was described in terms of relationship and religion in terms of rules. Four themes emerged to describe spiritual needs during an inpatient hospitalization: comfort, companionship, conversation, and consolation. Eleven succinct interventions were identified within these themes. The number one need expressed by consumers of all denominations and religions who belonged to a church/temple/spiritual group was for their pastor/rabbi/spiritual advisor to not abandon them. For those who did not belong to a religious/spiritual group their number one need was to at least be asked for some type of religious/spiritual preference and for the nurse to somehow contact the person mentioned.     

When an Alcoholic Employee Returns to Work:

A study of 115 employees referred to an alcoholism treatment center were studied to determine problems encountered when the employee returns to work. Although treatment was successful for the majority of employees, both supervisors and employees had concerns that reflected a lack of understanding about alcoholism and the recovery process.     

When therapists do not want their clients to be homosexual: a response to Rosik's article

This commentary is a response to Rosik's "Motivational, Ethical, and Epistemological Foundations in the Treatment of Unwanted Homoerotic Attraction" (this issue). Such treatment raises complex questions that cannot be resolved by focusing on the therapist's conservative versus liberal values. Most such clients are deeply ambivalent about their homosexual attractions. The degree to which their homosexuality is "unwanted" is highly variable among them and sometimes within them over time. Clients who are exclusively homosexual are very unlikely to be able to change their sexual attractions, whereas some clients who are bisexual may be more able to "manage" their homoerotic attractions (acting only on their heterosexual feelings). Marriage and family therapists should be able to support a client along whatever sexual orientation path the client ultimately takes, and the client's sense of integrity and interpersonal relatedness are the most important goals of all.     

When it pays to be friendly: employment relationships and emotional labour in hairstyling

This article examines worker‐client relationships in hairstyling. Data are drawn from interviews with 15 hourly‐paid and 32 self‐employed hairstylists and a self‐administered survey. Relations of employment are found to be central to the deployment of emotional labour. Self‐employed owner‐operators are highly dependent on clients, rely on deep‐acting, enact favours, and are prone to emotional breaking points when they fail to realise their ‘congealed service’. In contrast, hourly‐paid stylists perform surface acting, resist unpaid favours and experience fewer breaking points. Methodologically this article demonstrates the importance of comparative employment relations analysis (CERA) for exposing the relationship between employment structures and labour process experiences.     

Autism in Special and Inclusive Schools: 'there has to be a point to their being there'

What kind of schools are most suitable for pupils affected by autism? This article reviews meanings of autism and autistic spectrum disorders (ASD). We report evidence from observations in schools and interviews with pupils and adults, drawing on a qualitative study of special education in two contrasting education authorities one with special autistic schools, the other with inclusive schools. Current theory, policy and practice in the education of pupils with autistic tendencies are discussed in relation to the data.     

Parents and patients: Members of an interdisciplinary team on an adolescent inpatient unit

In a six-year study on a locked psychiatric hospital unit for adolescents, first patients and then their families became integrated into the interdisciplinary treatment team. The results were universally beneficial. After initial resistance and some fine tuning of their skills, the staff became strong supporters of the program. Parents, no longer one down, developed a close working relationship with the therapists and milieu staff. Treatment planning and implementation was enriched by the interaction and dissension was minimized. Most important of all, the adolescents improved more rapidly and hospital stays were significantly shortened.     

When Adoption Is Not an Option: Counseling Implications Related to Surrogacy

Through the author's personal story, this article details a case in which traditional conception and adoption were not options available for starting a family. It gives the author's rational for choosing surrogacy and describes his experience with surrogacy. This article provides an overview of the surrogacy process and concludes with implications counselors may consider and apply to their clinical practice.     

Revising a medication education program on an inpatient child and adolescent psychiatric unit

Adherence to a medication regimen can be challenging for children and adolescents with mental health disorders. Medication education can be a beneficial tool for nurses to help promote adherence to psychotropic medications. This article describes an initiative to improve medication education offered to children and adolescents and their families on an acute child and adolescent inpatient unit in a mental health facility. Strategies included adding a game to medication education groups, creating and distributing medication education handouts, and developing and implementing medication education sessions for parents. When used by the patients and families, the interventions were appreciated. Having successful interventions in place may help meet the diverse educational needs of this population as nurses seek to improve medication adherence.     

Climate control: creating a multifaceted approach to decreasing aggressive and assaultive behaviors in an inpatient setting

Creating an environment that is safe for everyone is a goal for all inpatient mental health units. How to address the aggressive and assaultive behaviors is the challenge. This article discusses how using a multidisciplinary team with a variety of approaches can help create a culture that supports safety.     

How to deal with sexual acting-out on the child psychiatric inpatient ward.

1. Although the management of sexually abused children is not new, a comprehensive approach is often lacking, especially as it pertains to dealing with sexually acting-out children. 2. In addition to the usual social work measures of child protection, a program of developmentally and psychoeducationally based interventions supplemented by behavioral techniques were found to be most effective. 3. Acting-out children often provoke reactions of rage, betrayal, and impotence among the staff. Discussions of interventions must take into account the staff's own philosophy about how sexuality should be taught to these children. 4. The treatment team leader must decide whether the sexual acting-out among children is due to active solicitation from sexually abused children, delinquent acting-out, or age-appropriate exploration.     

The Relative Salience of Facial Features When Differentiating Faces Based on an Interference Paradigm

Research on face recognition and social judgment usually addresses the manipulation of facial features (eyes, nose, mouth, etc.). Using a procedure based on a Stroop-like task, Montepare and Opeyo (J Nonverbal Behav 26(1):43?C59, 2002) established a hierarchy of the relative salience of cues based on facial attributes when differentiating faces. Using the same perceptual interference task, we established a hierarchy of facial features. Twenty-three participants (13 men and 10 women) volunteered for the experiment to compare pairs of frontal faces. The participants had to judge if the eyes, nose, mouth and chin in the pair of images were the same or different. The factors manipulated were the target-distractive factor (4 face components?×?3 distractive factors), interference (absent vs. present) and correct answer (the same vs. different). The analysis of reaction times and errors showed that the eyes and mouth were processed before the chin and nose, thus highlighting the critical importance of the eyes and mouth, as shown by previous research.