Domestic violence cases involving children: effects of an evidence-based prosecution approach

This article reports findings from the evaluation of a city-county criminal prosecution unit for domestic violence involving children. Data from 446 cases prosecuted in the first 2 years of the Joint Prosecution Unit (JPU) were compared to a matched group of 446 domestic abuse cases prosecuted by both the city and county attorneys' offices in the 2 years prior to inception of the JPU. Results of the comparisons indicated that fewer cases were declined or dismissed by the new unit, and that cases were prosecuted at a significantly more stringent level. Multinomial logistic regression analysis indicated that child and weapon factors were associated with increased likelihood of a more serious (i.e., felony) plea for the new prosecution unit, relative to the comparison group. Results are presented in the context of addressing the difficulties inherent in the prosecution of domestic abuse and in light of the increasing awareness of the detrimental effects of domestic violence on children.     

Engaging families in child welfare services: an evidence-based approach to best practice

Successfully engaging clients in the helping process is a critical task for child welfare practitioners. Drop-out and noncompliance rates in child welfare services are high and lead to high rates of removal of children from their families and to eventual termination of parental rights. Although no known interventions guarantee treatment compliance, this review of the empirical literature delineates critical components of engagement in child welfare services. Effective engagement strategies, including service components and caseworker qualities and behaviors, are identified as contributing to the positive case outcomes of treatment compliance, family preservation, and placement prevention. The unique needs of neglectful parents are also examined, with recommendations for practice.     

Building an evidence-base for the training of evidence-based treatments in community settings: Use of an expert-informed approach

In order to make EBTs available to a large number of children and families, developers and expert therapists have used their experience and expertise to train community-based therapists in EBTs. Understanding current training practices of treatment experts may be one method for establishing best practices for training community-based therapists prior to comprehensive empirical examinations of training practices. A qualitative study was conducted using surveys and phone interviews to identify the specific procedures used by treatment experts to train and implement an evidence-based treatment in community settings. Twenty-three doctoral-level, clinical psychologists were identified to participate because of their expertise in conducting and training Parent–Child Interaction Therapy. Semi-structured qualitative interviews were completed by phone, later transcribed verbatim, and analyzed using thematic coding. The de-identified data were coded by two independent qualitative data researchers and then compared for consistency of interpretation. The themes that emerged following the final coding were used to construct a training protocol to be empirically tested. The goal of this paper is not only to understand the current state of training practices for training therapists in a particular EBT, Parent–Child Interaction Therapy, but also to illustrate the use of expert opinion as the best available evidence in preparation for empirical evaluation.     

Resolving alcohol problems using an online self-help approach: moderation management

As illustrated by the emergent MM approach discussed in this article, a paradigm shift is occurring in relation to how alcohol problems are defined and managed. Moreover, one of the most interesting aspects of this transformation is the way in which similar belief systems are simultaneously emerging from divergent lay and professional groups. In spite of this flurry of activity and optimism, however, nurses should not embrace new frameworks and treatment strategies. Rather, the charge to our discipline and others is to think critically, research the effectiveness of newly proposed treatment approaches, and recommend and implement promising strategies with discernment.     

Return to work with chronic low back pain: using an evidence-based approach along with the occupational therapy framework

This paper will attempt to apply the occupational therapy framework [1] along with an evidence-based approach and an occupation-based intervention with a population of workers with chronic low back pain (CLBP) to help them return to work and maintain their work status. This paper will focus primarily on those clients with CLBP who still have a link to their employment but who do not perceive themselves as being capable to go back to their job despite conflicting opinions from other stakeholders (primary health care professionals, employer or insurer). They are being evaluated in occupational therapy shortly before return to work and followed until their optimal functional capacities are reached. This means that either all functional goals related to the actual physical demands of their job have been reached or that further treatment does not result in functional improvement.     

An evidence-based approach to lifestyle interventions in urogynaecology

Urinary incontinence, urgency, overactive bladder symptoms, cystitis and urinary tract infections are common conditions that collectively trouble over one-third of the female population around and beyond the time of menopause, with a detrimental effect on physical, social and mental wellbeing. Apart from pharmacological and surgical treatments, a long list of lifestyle, behavioural, physical and complementary interventions have been introduced over the years to relieve lower urinary tract symptoms. This review examines the effect on these symptoms of lifestyle factors (such as weight, smoking, dietary components, fluid intake, exercise and bowel habit), complementary therapies (such as herbal remedies, acupuncture and hypnotherapy), behavioural therapies (bladder training and timed and prompted voiding), pelvic floor muscle training and some over-the-counter preparations. The high prevalence of the above conditions in combination with the increasing publicity for and awareness of the subject has contributed to the popularity of the interventions considered in this review. Many of them, however, lack a solid evidence base with regard to their efficacy and few have been subjected to robust randomized trials. It is widely recognized that there is a need for further prospective interventional studies of all lifestyle interventions to evaluate the effects of modifying these factors on lower urinary tract symptoms.     

Exploration of factors predictive of at-risk fathers' participation in a pilot study of an augmented evidence-based parent training program: A mixed methods approach

There has been burgeoning parenting intervention research specifically addressing fathers in recent decades. Corresponding research examining their participation and engagement in evidence-based parent training programs, which have almost exclusively targeted mothers, is just emerging. The current study used mixed methods to examine factors that influenced completion of an augmented version of an evidence-based child maltreatment prevention program developed for male caregivers called SafeCare Dad to Kids (Dad2K) in a pilot study. The current sample comprised 50 male caregivers (M_age = 29.42 years, SD = 8.18) of a child between the ages of 2 and 5 years. Fathers participated in a baseline assessment and were considered program completers (n = 27) if they participated in the program's six home visiting sessions. A subsample of completers (n = 11) was recruited to participate in qualitative interviews that provided in-depth information about fathers' experiences in Dad2K. Logistic regression indicated that, in the context of other demographic predictors, fathers with an education beyond high school were over 5 times more likely to complete Dad2K program compared to fathers with a high school education or less. Qualitative analyses revealed that interviewed father completers were motivated to enroll and participate in a fathering program because of an interest to learn and obtain skills to make them a better parent. Fathers with a high school education or less may require additional engagement strategies to help proactively encourage their enrollment and completion of parent training programs.     

Dissemination of an evidence-based parenting program: Clinician perspectives on training and implementation

The present study used a qualitative approach to examine clinicians' experiences as trainees of an evidence-based parenting program, parent–Child interaction therapy (PCIT). In order to explore factors related to successful implementation and maintenance of the PCIT program in a community setting, twenty-nine community clinicians completed phone interviews six months to four years after an initial forty-hour PCIT training workshop. Clinicians reported positive experiences with the training, but also described barriers related to agency, client, program, and training factors. Findings suggest that (1) trainees view the core components of PCIT as acceptable and valuable, (2) training costs and problems with third-party reimbursement can impede implementation, (3) clinicians may benefit from training that includes skills in motivation enhancement, and (4) ongoing consultation is valuable to clinicians, although trainees differ in their preferences regarding the manner of delivery (e.g., teleconference, live). This study brings clinicians into the conversation regarding barriers to and facilitators of evidence-based training and implementation.     

Development of an evidence-based conceptual framework for workplace assessment

One solution to the underutilization of workplace accommodations is to use teleconferencing technology to conduct remote assessments, effectively expanding the geographical area that experienced rehabilitation specialists can cover. However, such an effort requires a highly structured and comprehensive assessment protocol. This paper reports on the analysis of 53 existing assessments to develop a conceptual framework for assessment and the use of that framework to evaluate the applicability of 10 work-related assessment protocols for remote tele-assessment. While none of the 10 protocols were found to be sufficiently comprehensive for our purposes, the conceptual framework itself will serve as an important tool to structure a new comprehensive protocol that will be developed. Moreover, the framework can also be used by providers of workplace assessments to evaluate the suitability of any assessment protocol to meet the needs of any particular individual or workplace situation.     

Unlocking Hikikomori: an interdisciplinary approach

This article provides an interdisciplinary exploration of the ways in which social isolation is constructed in institutional and public imaginaries. It examines the discursive devices that produce hikikomori subjectivities, with a particular focus on the existence of an enduring deviant construct. Despite largely existing in the private sphere, hikikomori are positioned as residing outside of the prevailing system of social relationships and as such are perceived as a threat to social order. Persistent psycho-medical and idiosyncratic cultural depictions of hikikomori continue to obscure those who are doing the defining. Such portrayals also re-assert enduring normative expectations concerning the social, civil and economic participation of young people. Through an interdisciplinary approach that blends sociological and cultural critique, this paper challenges the dominant discourses framing hikikomori, at the same time underlining the ways in which these limiting discourses act upon the self by reinforcing an individualised subjectivity, masking the network of institutions and cultural discourses that mediate this process. We assert that there needs to be a broadening of the concept away from the atomised individual to one that situates hikikomori within a social and cultural context, having significant implications for identity and notions of personhood in contemporary, digital Japan and beyond.     

Statewide dissemination of an evidence-based practice using Breakthrough Series Collaboratives

The emerging field of implementation science has begun to inform the increasing efforts to disseminate evidence-based practices. The Breakthrough Series Collaborative (BSC) model was used to disseminate trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut over three years. Participants were 179 outpatient clinical staff across 16 community-based agencies that implemented TF-CBT. A total of 588 children and families received TF-CBT. Children completing treatment showed significant reductions in PTSD and depression symptoms. Quantitative and qualitative data about the BSC model are presented. The BSC is a promising approach for dissemination of evidence-based practices, and recommendations for additional research on BSCs and sustainment of evidence-based practices are made.     

Recent developments in family psychoeducation as an evidence-based practice

Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and implementation since 2001, updating the previous review in this journal (McFarlane, Dixon, Lukens, & Lucksted, Journal of Marital and Family Therapy 2003; 29, 223). Research on a range of FPE variations continues to return mostly positive effects for adults with schizophrenia and increasingly, bipolar disorder. More recent studies include functional outcomes as well as the more common relapse and hospitalization. FPE research involving adults with other diagnoses is increasing, as is FPE research outside the United States In both cases, uneven methodologies and multiple FPE variations make drawing conclusions difficult, although the core utility of access to information, skill building, problem solving, and social support often shines though. Since the previous review, several FPE programs for parents of children or youth with mood disorders have also been developed, with limited research showing more positive than null results. Similarly, we review the developing inquiry into early intervention and FPE, short-form FPE, and cost studies involving FPE. The second half of the article updates the paradox of FPE's evidence base versus its persistently low use, via recent implementation efforts. Multiple challenges and facilitating factors across healthcare systems and financing, individual programs and providers, family members, and consumers shape this issue, and we conclude with discussion of the need for empirical evaluation of implementation strategies and models.     

Reforming child welfare: an integrated approach

Throughout the 1990s, child welfare systems were exposed to intense pressure. As a result, most systems have undertaken processes of reform and change. This article discusses the strategic development of New Zealand's service system in child welfare. A partnership between managerial discipline and professional leadership has been critical in the service system reform. With respect to management, a strong vision, a culture of high performance, and greater organizational stability and confidence provided the platform on which professional reforms could be established-including the knowledge framework, the service model, the practice package, and staff support. The managerial efforts that have provided the platform for the professional reforms are discussed, followed by an exploration of the professional reform package.     

Voting power: an information theory approach

In recent years, there has been increasing awareness of the importance of formal measures of voting power and of the relevance of such measures to real life political issues. Nevertheless, existing measures have been criticized, especially because of their dependence on the unrealistic assumption that different coalitions have equal probabilities. In this paper we show that the classical problem of measuring voting power can be naturally embedded in information theory. This perspective on voting power allows us to extend measures of voting power to cases in which there are dependencies among voters. In doing so, we distinguish between two different notions of a given voter’s power—‘control’ and ‘informativeness’—corresponding, respectively, to the average uncertainty regarding the outcome of a vote that remains when all others have voted and the average uncertainty that is eliminated when only the given voter has voted. This distinction settles a number of well-known paradoxes and enables the study of voting power on the basis of actual political behavior at all levels.     

Risk factors for attrition from an evidence-based parenting program: Findings from the Netherlands

Parent management training programs for the treatment of childhood conduct problems are increasingly being transported from their country of origin to international settings. Family interactions, however, may be influenced by different cultural expectations and children's mental health problems may be addressed within different systems. Demonstrating reductions in symptoms within the new population is insufficient to support the wide-scale transport of a treatment model. Implementation outcomes such as the rates of treatment retention and factors related to treatment attrition must also be considered. We explored predictors of attrition in families from the Netherlands referred to the evidence-based parenting program Parent–Child Interaction Therapy (PCIT). Participants included 40 children with conduct problems (2–7 years; 68% boys) and their caregivers. Attrition (40%) was somewhat lower than findings with similar community samples in the US. Significant predictors of attrition were child age and maternal levels of internalizing symptoms. Low parental demandingness and high child compliance before start of treatment were related to early attrition within twelve treatment sessions. Meeting the needs of families at risk for attrition is an important goal for parent management training programs within and outside the US if families in need of services are to benefit from them.     

AIDS: A case management approach. The illinois experience

The Illinois Department of Children and Family Services provides through their Medical Foster Care Program substitute living arrangements for wards of the state with positive antibody tests, ARC, and AIDS. At present there are ten children (eight in Cook County) that fall into one of these categories. Half (5) of these children are infants under the age of one year. Three (3) are adolescents who were exposed through intravenous drug abuse and/or prostitution. Case illustrations and discussion together with case planning and management techniques are presented for two of the cases: an adolescent with a positive antibody test, and a three-year-old with AIDS. Current trends and future issues for investigation are also presented.     

A holistic approach to stakeholder management: A rhetorical foundation

The day-to-day concerns of managing stakeholders are a critical matter for public relations practitioners and scholars alike. “Stakeholder theory” subsumes the knowledge base about stakeholders, who are individuals and groups who affect or are affected by an organization's actions. This article argues that a holistic view of stakeholder management rests on rhetorical grounds and concerns answering three fundamental questions: (1) How are stakeholders created? (2) How can relationships with stakeholders be maintained? and (3) How can relationships with stakeholders be improved? Example cases are used to demonstrate how retrospective analysis reveals the effectiveness of stakeholder management approaches. Ultimately and most important, the combination of theory and case analyses are synthesized into a prospective approach to stakeholder management that organizations may use during strategic planning.