Methadone Maintenance as Last Resort: A Social Phenomenology of a Drug Policy

Drawing on qualitative interviews with drug addicts in Copenhagen, Denmark, this article offers a phenomenological reading of a methadone maintenance program. The program is set within the principles of harm reduction, meaning that its aim is not to cure the participants’ addiction but to keep them stable on substitution medicine and slow the deterioration of their lives. We analyze the program’s implications for participants’ sense of agency and constraint and for their orientations toward the past, present, and future. A major concern is with the program as a last resort policy that challenges neoliberal ideals of self‐governance and self‐development. While the program increases the participants’ sense of stability by providing them with methadone and by allowing them to better address their economic, housing, and other needs of everyday life, it also represents a context of physical, emotional, and social dependence. The interviews cast the program as a paradox that simultaneously increases participants’ sense of stability and vulnerability. In essence, the Danish methadone program has the effect of both helping the participants by reducing the drug‐related harm in their lives and of fostering conditions of inferiorization and enduring nonbecoming.     

Briefly Noted

The biennial International Drug Policy Reform Conference, sponsored by the Drug Policy Alliance and held Nov. 7–9 in St. Louis, Missouri, was full of varying sessions on harm reduction and reform — 45 of them in all. An article by Filter editor Will Godfrey summed up his perspective — he was the only print reporter so far to have covered the entire conference. We asked him what his feeling was about the prospects for treatment and harm reduction working together, as they have in the past. “There's plenty of friction, but there can and should be rapprochement between the harm‐reduction and traditional treatment communities,” he told ADAW. “Many people in the harm‐reduction movement pursue traditional recovery, and there are treatment folks who support harm reduction. All should be trying to save lives and empower people. Harm reductionists' legitimate concerns about mainstream treatment include its coercive or controlling deployment, its frequent eschewal of evidence‐based practices and its promotion of abstinence at the expense of stigmatizing people who use drugs. Treatment advocates often overlook that most people who use drugs are fine. And in any case, everyone must be free to choose their own path.” But the fact that two approaches — one more radical than the other — coexist still is bound to make some treatment providers uncomfortable. After all, some of the speakers said that even supervised consumption sites are unfair to drug users, who have no need to be “supervised,” and instead should be free to use drugs. All viewpoints were there. “There's constant debate in the harm‐reduction movement about working to change systems that inflict harm from the inside, versus calling for radical reforms from the outside,” said Godfrey. “I think both approaches are simultaneously necessary.” Not everyone saw the conflict. “I have to say that I didn't see an anti‐public health movement there at all,” Maia Szalavitz, who is writing a history of harm reduction and is respected in both harm reduction and some, at least, treatment camps, told ADAW. “There has always, of course, been tension between activists and researchers and between people who want to fight within the system and those who want to tear it all down.” For the Filter article, go to https://filtermag.org/drug‐policy‐reform‐movement/ .     

We are strong and we are resilient: Career experiences of women engineers

With the purpose of breaking down socially derived, implicit assumptions regarding women and highlighting their resilience and strength within organizations, this study focused upon career experiences of women engineers. Findings indicated women constantly navigated gendered social and organizational norms to develop their careers. We found them to employ three distinct coping strategies, conforming to play by the rules, negotiating to play around the rules and defying to establish own rules. The ways in which participants arrived at and enacted on these coping strategies is illustrative of their strength, forethought and self‐directedness. All participants demonstrated high self‐concept and the ability to learn and adapt. The study allowed us to acknowledge prevalence of gendered norms and expectations, while also highlighting women's strength in navigating their careers. We hope that the study is able to illuminate persistence of male perspective in the literature and promote a perspective of women as strong and resilient professionals.     

Spousal Abuse Among Immigrants From Ethiopia in Israel

This ethnographic study obtains first‐hand information on spousal abuse from Ethiopian immigrants in Israel. Data include 23 interviews with male and female immigrants of various ages and 10 professionals who worked with this community as well as observations and documents. The findings, verified by participants, show that during cultural transition, the immigrants’ code of honor, traditional conflict‐solving institutions, and family role distribution disintegrate. This situation, exacerbated by economic distress, proved conducive to women’s abuse. Lack of cultural sensitivity displayed by social services actually encouraged women to behave abusively toward their husbands and destroy their families. Discussion focuses on communication failures in spousal‐abuse discourse between immigrants from Ethiopia and absorbing society, originating in differences in values, behavior, social representations, and insensitive culture theories.     

Clients’ perceptions of marriage and family therapists’ way‐of‐being: a phenomenological analysis

Previous research highlights the influence of therapist factors on treatment outcomes. One therapist factor proposed as fundamental to the process of therapy is the therapist's way‐of‐being, a relational concept that refers to how the therapist regards a client—either as a person or object (Fife et al., [2014] Journal of Marital and Family Therapy, 40, 20–33). Although this case has been made conceptually, there is little empirical research on therapists’ way‐of‐being with clients. The primary purpose of this research is to investigate clients’ perceptions of their therapists’ way‐of‐being. Utilizing a common factors perspective, the study seeks to explore: (a) how clients experience their therapists’ way‐of‐being and (b) the influence therapists’ way‐of‐being has on clients’ engagement. Phenomenological methods were used to gain a nuanced understanding of the phenomenon. Qualitative data were collected through semi‐structured face‐to‐face interviews with clients (N = 10) who received individual therapy from a marriage and family therapist. Results were organized into two main themes: core tenets (attunement, congruency, and aligning with clients) and operational tenets (providing affirmation and validation, balancing flexibility and structure, and accomplishing goals). Findings are used to make a case for adding the concept of way‐of‐being as an overarching construct for several well‐established therapist factors. Clinical and training implications are discussed.     

“Power in Numbers”: Youth Organizing as a Context for Exploring Civic Identity

This study examines civic identity exploration among African‐American and Asian‐American urban youth who participated in a grassroots organizing campaign to improve their local high schools. Drawing on 9 months of ethnographic fieldwork and interviews with participants, the study found that the campaign provided a venue for participants to wrestle with contrasting perspectives about the relationship between the individual and the broader public. The first perspective, which I call atomism, described local social relations as individualistic and self‐interested. The second perspective, which I call collective agency, emphasized that people should work together toward common goals and that the more people who were involved, the more powerful the effort would be. Implications of youth organizing for civic identity formation are discussed.     

Discrepancies Between Retrospective and Actual Self‐Reports of Peer Victimization Six Years Earlier

Retrospective peer victimization reports may be inaccurate. With an ethnically and sexually diverse sample, this study compared adolescents’ self‐reported peer victimization in 6th grade to their own retrospective reports of 6th‐grade victimization when they were in the 12th grade, controlling for past and current adjustment. Overall, 12th graders’ retrospective victimization reports correlated with their own earlier 6th‐grade self‐reports and there was a general tendency to underreport retrospectively. Underreporters were distinguished by worse past 6th‐grade adjustment, whereas overreporters were distinguished by worse current (12th‐grade) adjustment. Higher current depressive symptoms and social anxiety, and lower current self‐worth may be important control variables when collecting retrospective reports of victimization because current adjustment may augment participants’ recollection of past experiences.     

Social Support and Academic Engagement Among Reconnected Youth: Adverse Life Experiences as a Moderator

Using motivational theories of engagement and adopting a multidimensional perspective of academic engagement, the authors investigate the associations among teacher and parent support, students’ academic self‐efficacy, and academic engagement among a sample of reconnected youth who have returned to academic pursuit after dropping out (N = 938, mean age = 16.50, SD = 1.78). In addition, they examine how youth's adverse life experiences moderate the pathways in this model, an analysis notably missing from much of the academic engagement literature. They find that students’ academic self‐efficacy mediates parent and teacher support and youth academic engagement. Moreover, participants’ adverse life experiences moderate the connections among perceived support from parents, academic self‐efficacy, and academic engagement. Implications for practice and future directions are discussed.     

The Impact of HIV Pre-exposure Prophylaxis (PrEP) Use on the Sexual Health of Men Who Have Sex with Men: A Qualitative Study in Seattle,WA

This study explores the impacts of HIV pre-exposure prophylaxis (PrEP) use on the sexual health of men who have sex with men (MSM). The authors conducted in-depth interviews with MSM who use PrEP (n = 14). Data was analyzed using interpretative phenomenological analysis. PrEP use reduced fear and shame associated with sex and facilitated greater sexual satisfaction and intimacy. Although participants generally viewed PrEP as empowering and beneficial, they also experienced PrEP-related stigma. The authors’ analysis emphasizes the importance of understanding the reasons MSM use PrEP and highlights opportunities for reducing harm and fostering sexual health among MSM who are using or considering PrEP.     

Recording and Interpreting Work‐Related Daydreams: Effects on Vocational Self‐Concept Crystallization

This mixed‐methods study examined the effects of recording and interpreting work‐related daydreams on vocational self‐concept crystallization and attitudes toward daydreams. Fifty‐one college students were assigned to 1 of 2 experimental groups—daydream journal group (n = 15) and daydream interpretation group (n = 18)—and a control group (n = 18). Data were analyzed using analyses of covariance. At posttest, both experimental groups showed higher levels of vocational self‐concept crystallization than the control group, and the daydream interpretation group perceived their daydreams as more relevant than the control group. Qualitative data were collected via written postintervention surveys and embedded as a supplement to the quantitative design. The qualitative data support the findings that participants in the experimental groups gained a greater awareness and clarity regarding their vocational self‐concepts and a greater belief in the relevancy of work‐related daydreams.     

The Self‐Directed Search as a Stand‐Alone Intervention With College Students

The Self‐Directed Search (SDS; Holland, 1994 ) is sometimes administered to large student groups outside of counseling to address common career development needs. This study evaluated the effectiveness of the SDS as a stand‐alone intervention by comparing a general sample of college students who completed the SDS (n = 39) with a no‐treatment control group (n = 41) on several outcomes. Completion of the SDS related to an increase in the number of career alternatives being considered 4 weeks later but did not relate to career exploration, career decision‐making self‐efficacy, career indecision, and seeking of career counseling services. If the SDS is used outside of counseling with broad student samples, the authors suggest providing additional intervention to ensure that it promotes exploration of any additional careers being considered.     

Evaluating FOCUS‐2's Effectiveness in Enhancing First‐Year College Students’ Social Cognitive Career Development

This study examined the effectiveness of the computer‐assisted career guidance system, FOCUS‐2, on 1st‐year college students’ social cognitive career development. Specifically, the authors assessed career decision self‐efficacy (CDSE) and assessment of attributions for career decision making (AACDM) using repeated measures analyses of variance with a sample of 1st‐year college students (N= 420). Effectiveness was measured as a change in participants’ CDSE and AACDM scores from pretest to posttest. Results demonstrated that participants’ interaction with FOCUS‐2 was associated with increases in participants’ CDSE and alteration to a less optimistic style for AACDM. Gender, race, academic major status, and the amount of time using FOCUS‐2 were also considered. Implications for practice are explored.     

Relative Deprivation and Career Decision Self‐Efficacy: Influences of Self‐Regulation and Parental Educational Attainment

Nearly 70% of Korean women pursue postsecondary education, yet they occupy lower‐status positions than do men (K. Kim & Han, 2008 ). Therefore, the authors examined relative deprivation in equal opportunities and its effect on career‐related self‐efficacy among 603 Korean female college students. Self‐regulation was hypothesized to mediate the effects of relative deprivation on career decision self‐efficacy. This effect was hypothesized to differ according to parents’ educational attainment due to different degrees of parental support. As expected, self‐regulation mediated the relationship between relative deprivation and career decision self‐efficacy for participants whose parents had high education levels. However, participants whose parents had low education levels demonstrated less involvement in resolving relative deprivation. Findings suggest that career counselors should use different interventions based on parental education level to influence students’ self‐regulation and to enhance career decision self‐efficacy.     

REVELATION MECHANISMS AND ALLOCATIVE EFFICIENCY

We show that revelation mechanisms affect owners' valuations of the assets they own and that different mechanisms provide owners with the incentive to reveal—truthfully—different valuations. Self‐assessment of property with compulsory sale at the self‐assessed price is the only known mechanism that promotes allocative efficiency by providing efficient incentives for transferring property to those who value it most. We introduce two modifications of the standard self‐assessment mechanism that maintain full incentives to invest and raise as much public revenue as can be raised efficiently. (JEL D61, D82, H21, K11)     

Usefulness and Reliability of Tanner Pubertal Self‐Rating to Urban Black Adolescents in South Africa

Self‐rating of pubertal development is the recommended method to assess puberty in large community‐based surveys of adolescent development and behavior. The aim of this study was to validate for the first time pubertal self‐assessment using the sexual maturation scale developed by Tanner among Black South African adolescents (n=182) aged between 10 and 18 years who were recruited and assessed at public schools in Soweto—Johannesburg. There was significant concordance between adolescents' and same sex health professional's assessment of pubic hair growth and breast development in females (κ coefficients .71 and .76, respectively; p<.0005), and pubic hair growth and genital development in males (κ coefficients .63 and .60, respectively; p<.0005). We conclude that the Tanner pubertal self‐rating appears to be a reasonably valid instrument to use among black South African youth. The tool can be administered in school or other community‐based settings with moderate confidence provided the procedure is thoroughly explained to the participant through the developed tutorial in the language of choice, and privacy and confidentiality are assured.     

Profiles of Emotion Deficits and Adolescent Nonsuicidal Self‐Injury in an Inpatient Sample

This study examined profiles of specific emotion deficits, including poor emotion awareness, reluctance to express emotion, sadness inhibition and dysregulation, and anger inhibition and dysregulation. Self‐report questionnaires assessed adolescents’ emotion skills and nonsuicidal self‐injury (NSSI) engagement, frequency, severity, methods, and age of onset. Latent profile analysis yielded a three‐profile solution: Low Deficit (LD; n = 49), Unaware/Anger Dysregulated (UAD; n = 24), and Anger Inhibited (AI; n = 20) profiles. Adolescents in the UAD profile were more likely to engage in NSSI, displayed a higher NSSI frequency, and reported a higher number of NSSI methods when compared to adolescents in the LD profile. No links emerged for NSSI severity or age of onset.     

Assessing University Students’ Self-efficacy to Employ Alcohol-Related Harm Reduction Strategies

Abstract

Objective: Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers’ self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking. Methods: Four hundred ninety-eight participants rated their confidence (from “not at all confident” to “completely confident”) to employ 17 harm reduction strategies when drinking. Results: Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test–retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks. Conclusion: This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.     

Are They Really Mama’s Boys/Daddy’s Girls? The Negotiation of Adulthood upon Returning to the Parental Home

This article explores how living with parents affects the ways emerging adults construct their self‐identity. Data are from in‐depth interviews with 30 young adults who returned to live with their origin family after a period of residential autonomy. Respondents perceive adulthood as a psychological state, attained through a process of assuming responsibility for one’s actions and learning how to interact with other adults (particularly parents) from a position of equality. Nonetheless, an economic component remains important, mentioned by respondents who contributed to the family economy and those who sought to avoid doing so. Successfully viewing oneself as an adult is gendered, with daughters less likely to perceive themselves as equals in interactions with parents.     

From sociolinguistic variation to socially strategic stylisation1

This article investigates the indexical relation between language, interactional stance and social class. Quantitative sociolinguistic analysis of a linguistic variable (the first person possessive singular) is combined with interactional analysis of the way one particular variant (possessive ‘me’, as in Me pencil's up me jumper) is used by speakers in ‘stylised’ interactional performances. The aim of this analysis is to explore: (1) how possessive ‘me’ is implicated in the construction and management of local identities and relationships; and (2) how macro‐social categories, such as social class, relate to linguistic choice. The data for this analysis comes from an ethnographic study of the language practices of nine‐ to ten‐year‐old children in two socially‐differentiated primary schools in north‐east England. A secondary aim of the article is to spotlight the sociolinguistic sophistication of these young children, in particular, the working‐class participants, who challenge the notion that the speech of working‐class children is in any way ‘impoverished’.     

Self‐Focused Attention and Career Anxiety: The Mediating Role of Career Adaptability

The purpose of this study was to examine how 2 forms of self‐focused attention, self‐reflection and self‐rumination, influence career anxiety. The authors hypothesized that the association between these 2 types of self‐focused attention and career anxiety would be mediated by career adaptability on the basis of a career construction model of adaptation. The participants were 326 undergraduate students in South Korea. The results of this study supported the hypothesized mediation model by indicating significant indirect effects of self‐reflection and self‐rumination on career anxiety via career adaptability. The direct effect of self‐rumination on career anxiety was significant (B = .44, p < .01), but the direct effect of self‐reflection on career anxiety was not significant (B = –.05, p > .05). The authors discuss implications for counselors to help college students manage career anxiety by encouraging and supporting increased career adaptability. Future research to examine the cross‐cultural validity of the current findings is needed.