The Diagnostic/Therapeutic Preabortion Interview

Abstract

This paper discusses the therapeutic and diagnostic aspects of the preabortion interview, giving attention to those specifics which will help identify students with the greatest likelihood for psychological sequelae and for repeat abortions. The circumstances of the pregnancy change what should be a “normative life crisis” in a planned pregnancy into an acute emotionally and physically intrusive crisis when it is unwanted. The openness of sexually active partners on today's campuses, along with liberalized abortion laws, have generated a sharply increased demand for abortions, and a significant population of young college women seek help from their Student Health Services. Rising expectations for care require optimal coordination of Gynecology and Mental Health Clinics.     

More Than Help? Volunteerism in US Latino Culture

Volunteerism makes critical contributions to individual lives and society as a whole. However, to date, few studies have investigated volunteerism within Latino communities, a large and growing US population. The aim of this study was to understand how non-metropolitan US Latinos perceive volunteerism, as well as to determine what motivates and what deters their participation in volunteer programs. Our research team conducted six focus groups with 36 Latina women living in the State of Illinois. The focus groups covered topics such as the definition of volunteerism, participation motives and barriers, personal volunteer experience, and Latino culture, community, and organizations. We also assessed demographic information. Results from this study indicate that Latinas have a unique understanding of the concept of volunteerism. Participants associated everyday “helping” with volunteerism, establishing commonplace forms of aid as perhaps a “Latino way of volunteering.” We found time-consuming activities such as family responsibilities and work to be deterrents to Latinas participating in more formal volunteer activities.     

Brief admission program. An alliance of inpatient care and outpatient case management

1. Brief planned and crisis admissions to an inpatient psychiatric unit are presented as a component supportive of outpatient care and case management for chronically mentally ill patients. 2. Typical patients admitted to this inpatient short-term program are those experiencing a life stress or temporary crisis; chronically mentally ill patients who cycle and experience exacerbations of their illness; and those who need to make the transition from an acute inpatient unit to community living. 3. The Brief Admission Program treats the individual's response to and the consequences of a lifelong illness and enables the patient to return to his previous level of functioning and continue necessary outpatient treatment.     

Pension Reform in China

This article analyzes China’s pension arrangement and notes that China has recently established a universal non-contributory pension plan covering urban non-employed workers and all rural residents, combined with the pension plan covering urban employees already in place. Further, in the latest reform, China has discontinued the special pension plan for civil servants and integrated this privileged welfare class into the urban old-age pension insurance program. With these steps, China has achieved a degree of universalism and integration of its pension arrangement unprecedented in the non-Western world. Despite this radical pension transformation strategy, we argue that the current Chinese pension arrangement represents a case of “incomplete” universalism. First, its benefit level is low. Moreover, the benefit level varies from region to region. Finally, universalism in rural China has been undermined due to the existence of the “policy bundle.” Additionally, we argue that the 2015 pension reform has created a situation in which the stratification of Chinese pension arrangements has been “flattened,” even though it remains stratified to some extent.     

Briefly Noted

At last week's annual conference of the National Association for Behavioral Healthcare (NABH), the increase in managed care figured prominently as causing a significant barrier to access to treatment. “The issue that is front and center is access to care, the problems that people are having getting necessary care, and not being able to access the right care at the right time,” NABH President and CEO Mark Covall told ADAW. In addition, the continuum of care has been severely impacted by managed care, he said. “Managed care companies are restricting care to crisis care only,” he said. This means that the longer‐term care needed for recovery when patients emerge from a crisis is not being covered. There are no clear legislative or regulatory fixes yet, said Covall, speaking by phone from the busy meeting. As an organization, NABH “will continue to be proactive and reach out to managed care companies,” he said. “We hope the collaboration that is desperately needed will be a two‐way street.” NABH members have reported that “it has been exceedingly difficult to get patients the care they need, and our members are saying that it's hurting patients, and this is not acceptable.” Last week, NABH launched Access to Care, an initiative “that will send our message to policymakers, regulators, payers and patient advocates that only true access to care can lead to recovery.”     

The operation and subversion of gendered war discourses: soldierhood,motherhood and military dissent in the public production of Kimberly Rivera

This article undertakes a discourse analysis of texts concerning a recent high profile case of opposition to war by Kimberly Rivera, a US soldier and a mother of five. Developing on previous research concerning how female soldiers, anti-war women and anti-war soldiers have been made intelligible within understandings of war and gender, the analysis traces the discursive repertoires constituting Rivera as a political subject. The article considers how, when and with what implications for broader discourses of gender and war, and their transformation, the categories of soldierhood and motherhood were invoked to construct and obstruct Rivera as an intelligible dissenting subject. The most common presentation of Rivera centered on her motherhood, understood to be in crisis due to her military role. With motherhood and soldierhood seen to be antithetical this crisis could be “solved” through opposition to war. This limited the extent to which Rivera was intelligible as a “thinking citizen” and reproduced motherhood and soldierhood as stable categories leaving their immanent discourses concerning war and gender untroubled. The article then considers ways in which alternative avenues for transformative interventions could open up if dissenters like Rivera were “written” as other than fundamentally contradictory figures.     

Program Evaluation of “Young at Heart”

Abstract

We conducted a program evaluation study of “Young at Heart,” a Texas (United States) program that places elderly volunteers in childcare settings. The main constructs evaluated in this research-based article are Erikson's generativity (a motivation to guide younger generations) and life satisfaction. We compared four groups of elderly persons on these constructs: Young at Heart volunteers, Meals on Wheels volunteers (who deliver food to other elderly persons and thus gain volunteer experience, but not with children), non-volunteers drawn from the general population of one Texas community, and individuals in the same community who volunteered in a variety of activities (“miscellaneous volunteers”). Our guiding assumption was that volunteering with children would appear to be a clear expression of generativity; we thus hypothesized that YAH volunteers would score highest in it. Contrary to prediction, the miscellaneous volunteers averaged the highest generativity, followed by YAH volunteers. Philosophical and conceptual issues are identified with regard to research on generativity and intergenerational programming.     

Teachers and health workers: partners in primary health care. Experiences from Papua New Guinea

Primary health care (PHC) involves community health education. When health priorities in rural communities are focused on the vulnerable under-5-years-of-age group then one has to examine who actually cares for this age group and what are the most appropriate means of reaching them through health education programs. In the context of rural communities in Papua New Guinea the linking of school and community health programs has been taking place. Examples and insights from programs where teachers and health workers attempted to find appropriate channels for integrating child and adult education in order to improve the health status of the very young child are described. The school programs used a child to child approach to develop in children a sense of shared responsibility with adults towards better health for themselves, younger children in their care and the environment of the community. The goal was a health program that applied to the whole community, where division between child and adult learning activities was not so sharply drawn, and where formal school programs and nonformal community education programs were to complement and contribute to each other. A campaign against infant diarrhea and death through dehydration was implemented. As a result of a 3-day planning workshop a program was drawn up for schools and communities. The workshop covered causes of diarrhea, fluid loss and dehydration, simple preventive and curative measures, essential hygiene habits and current community practices. Teachers, health workers and community leaders fashioned a program of activities for school children and adults. It was discovered that adults often feel a barrier between themselves and the child's school learning. Also, a gap often exists between what is taught in school and what is needed and can be applied to community health priorities. Thus, an effective community health education program that includes both children and adults in an integrated program will need to cover the varying ages and groups of community members who, with different degrees of responsibility, take care of themselves and others.     

“Making a plan”: responses amongst the wealthy to declining socioeconomic conditions in suburban Harare

Although the term “crisis” is often used to describe politico-economic conditions in post-2000 Zimbabwe, the period of hyperinflation in Zimbabwe was also accompanied by creative responses to declining socioeconomic conditions. In this paper, I consider the ways in which wealthy suburban Zimbabweans resident in Harare during this period dealt with the withdrawal of the state from some aspects of daily life: most notably, experienced through a decline in municipal services such as the provision of water and electricity. I argue that whilst poor urbanites experienced socioeconomic conditions as a decline in modernity even while they engaged in creative responses to those conditions, for wealthier (Black and White) urbanites the withdrawal of local government services led to a revival of ideas of innovation (“making a plan”) that were similar to a pre-Independence discourse of self-reliance in the face of economic sanctions imposed in the 1970s. Ideas of self-sufficiency and innovation in the present day were invoked by both Black and White respondents, and can be read as partly rhetorical, given the realities of complex engagements and negotiations that occurred in Harare between residents and the municipality and state services. The innovation required to “make a plan” was always complexly social: although people could no longer rely on local government for services, they were forced by the erratic nature of service delivery to rely upon one another, and to engage with municipal institutions and local government structures in ways that had previously been unnecessary. Attempts to maintain a “proper” life in Harare involved creating forms of community amongst the wealthy, and connections between the wealthy and the state, that had not necessarily existed before the so-called crisis.     

Creating “Community”? Preparing for Bushfire in Rural Victoria

The term “community” has a long and contested lineage in social analysis and debate. This lineage, however, is not generally recognized in policy and public debates on community and bushfire in Australia. “Community” is thought to be central to bushfire preparedness in Australia, especially in rural areas, but what “community” actually means in this context is vague at best. There is an ever‐present tension between the use of “community” as a reference to locality, a “sense of community” as experienced by residents, and the use of “community” as a rhetorical tool by governments and state agencies. We argue that a rigorous analysis of the concept of “community” is critical to an understanding of the processes involved in preparing for the challenges associated with disaster, in this case bushfires. These broader issues are supported by research (a series of surveys, interviews, and focus groups) carried out with residents living in (predominantly rural) bushfire‐prone areas in the state of Victoria, Australia. Ultimately, we assert that social participation and social networks are likely to be the crucial aspects of community that play a central role in effective bushfire preparedness.     

Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.     

Skills-Based Volunteering as Both Work and Not Work: A Tension-Centered Examination of Constructions of “Volunteer”

The Corporation for National and Community Service defines professional skills-based community service as “the practice of using work-related knowledge and expertise in a volunteer opportunity.” Traditional definitions of volunteer work in organizational communication scholarship, however, are typically based on (1) the bifurcation between work and volunteer activity; (2) low barriers to volunteer entry and exit; (3) the lack of managerial power/control over volunteers; and (4) the altruistic focus of volunteer work. An analysis of interviews with 19 skills-based volunteers highlights the identity and role tensions inherent in professional volunteering and serves as the basis for a proposal for a new way to visualize volunteering characterized by spectrums of tension rather than by the traditional lens of “not work.”     

THE FAMILY CRISIS INTERVENTION LITERATURE: WHAT IS MEANT BY “FAMILY”?*

Family crisis intervention is a rapidly growing area of clinical care in family therapy which lacks clear conceptualization, especially with respect to how “family” fits into crisis intervention theory. This paper integrates recent concepts from the family therapy literature into three views: family as background, family as context, and family as a unit. The family crisis intervention literature (56 publications) is reviewed and categorized according to these three views. Clarity in how “family” is viewed and consistency between theory and practice are examined. Recommendations for improving the conceptualization of “family” in family crisis intervention theory and practice are made.     

The New Landform's Here! The New Landform's Here! We're Somebody Now!! The Role of Discursive Practices on Place Identity*

Abstract On the border of western Iowa, a new landform—the “Loess Hills,” is being created. While scientific discourse surrounding the landform has been on going for a century, “discovery” of the landform by local residents is a recent occurrence, stimulated by socioeconomic changes resulting from the “farm crisis.” As this case study shows, the initial scientific discourse and claims, as presented in a series of publications, established the uniqueness and rarity of the hills in scientific terms. Through a complexity of discursive practices, this internalized scientific community discussion was brought into broader public conversations. Aspects of the discursive practices have been taken on by residents at the local level and appropriation of the “Loess Hills” name and facts attributed to the landform has resulted in reshaping place identity among rural residents and altering the traditional power position within the region, with “hill people” now becoming “Loess Hills People.”     

SOS—Satisfied or Stuck,Why Older Rural Residents Stay Put: Aging in Place or Stuck in Place in Rural Utah*

As rural communities undergo substantial demographic and economic changes, understanding the migration intentions and their antecedents of rural elderly persons becomes increasingly important. Using data drawn from a survey of adults from 24 rural Utah communities conducted in 2008, we examine whether rural residents 60 years of age or older plan to remain in their present communities (N= 621). We use structural equation models (SEM) to estimate the relationships between a variety of individual and community-level background measures, including perceptions of local service quality, leaving one's community for health care, Internet use, attachment to and satisfaction with community, and plans to age in place. Results suggest that even as the rural context of economic decline, population loss, and distance to medical services may reduce the viability of staying in a community, a desire to remain in the community is primarily a function of perceptions of the quality of local services and community satisfaction. This research highlights the need to better understand the interplay between the availability of medical services and perceptions of distance as well as to understand the complex relationship between individual and community level characteristics for migration intentions.     

“Romancing with a Wealth or Detail” Narratives or Ernest Jones's 1906 Trial for Indecent Assault

In March 1906 Dr. (Alfred) Ernest Jones was put on trial for indecently assaulting two young “mentally defective” girls at a special school in South East London. Jones claimed it was “the most disagreeable experience in [his] life.” A detailed reconstruction of the trial, drawn from contemporaneous records, reveals significant flaws in Jones's autobiographical account. Reading those records in the light of early psychoanalytic theory and recent British “political” texts on child sexual abuse—from “Cleveland,” “Orkney,” and “Jason Dabbs” through to “Lost in Care”—helps illuminate the dominant medicolegal ideologies that informed Jones's trial. Adapting Leo Strauss's concept of persecution reveals how details of the children's allegations were occluded from the trial reports. A jigsaw reconstruction of these silences offers a restitutive narrative of the children's persecuted speech.     

The genesis of public relations in British colonial practice

This paper fills a gap in the documentation of the evolution of public relations in the 20th century by demonstrating how the British Colonial Office employed public relations strategies and tactics in the administration of an African colony. This policy development traced primarily through British Colonial Office and Ministry of Information written and film archives in London, Zimbabwe and Zambia demonstrates how colonial officials in an Africa colony in conjunction with civil servants at the Colonial Office in London developed and implemented public relations policies, strategies and tactics on an ad hoc basis in response to the need for colonial officials to communicate and manage relations with colonial subjects in an intercultural setting.The case study is that of the British colony of Northern Rhodesia, the evolution of government public relations activities follows three distinct phases, before, during and after World War II and covers political public relations as well as community development activities and “education for citizenship.”     

Utilizing the moral nobility of older Chinese women in governance: The uses of humility,empathy, and an ethics of care in moral clinics in Huzhou city

This paper examines the emergence of the role of “moral doctors” who volunteer in what are called “moral clinics” in Huzhou city. In these moral clinics, the characteristics, experiences, and attributes of older women, in particular, are highly valued and viewed as being essential to the role of the moral doctor. These moral doctors act as moral exemplars and conflict mediators in their local communities. Their moral capital and professionalism, combined with their gender, age, familial and neighborhood attributes, contribute to the accumulation of an affective feminized labor which employs the techniques of care, reason, and moral fortitude to govern the self and others. We unpack these ethical virtues exemplified by moral doctors and nurses in order to show how a female-centric “ethic of care” can become a set of techniques in governing others. In this paper, we elaborate on the role that these moral doctors perform to support the aims of the moral clinics in terms of fostering pro-social behavior and moral obligation in local communities. We argue that the performance of this type of “moral work” is both a mechanism of discipline and a process of self-actualization. We contribute to the current literature on “therapeutic governance” in China by showing how the non-expert medicalization of social ills by moral doctors is incorporated into the reproduction of social control.     

Using face validity to recognize empirical community observations

There is a growing interest among international planning scholars to explore community participation in the plan making process from a qualitative research approach. In this paper the research assessment tool “face validity” is discussed as one way to help planners decipher when the community is sharing empirically grounded observations that can advance the applicability of the plan making process. Face validity provides a common sense assessment of research conclusions. It allows the assessor to look at an entire research project and ask: “on the face of things, does this research make sense?” With planners listening to citizen comments with an ear for face validity observations, holds open the opportunity for government to empirically learn from the community to see if they “got it right.” And if not, to chart out a course on how they can get it right.     

Are You Truly a Recovering Dope Fiend? Local Interpretive Practices at a Therapeutic Community Drug Treatment Program

Previous qualitative research on treatment programs for drug addiction/alcoholism has primarily focused on those processes whereby participants are expected to construct a new sense of self according to institutional parameters. The present article builds on that research and explores how contemporary programs attempt to resolve the problem that it is almost impossible to tell if someone has engaged in this self‐construction process. Informed by five months of ethnographic fieldwork at an adult residential drug treatment facility, the article asks: under what circumstances do program members call into doubt a client's efforts to create an institutional self, and how do they express this skepticism? The article reveals that staff and clients employ a set of local interpretive practices about community and emotions to assess whether clients are constructing the institutional self of a “recovering dope fiend.” It specifically considers how they interpret a client's emotional displays to represent that client's current self under construction. That is, a client's ability to control anger appropriately or to handle anxiety demonstrates s/he is effectively “doing the program” of self‐construction.