Girl Scouts Beyond Bars: a unique opportunity for forensic psychiatric nursing.

The interplay of victim and perpetrator roles experienced between daughters and their mothers provides for intricately complex interactions within a family and the community. Unique opportunities exist for forensic psychiatric nurses to articulate their nursing roles against health promotion and illness prevention programs for incarcerated women and their families. Participation in community-based projects allows forensic psychiatric nurses to observe and respond to the total environment of offenders and their families.     

‘Second-order’ ethnic minorities in Asian secessionist conflicts: problems and prospects

This article provides some conceptual foundations for a special issue of Asian Ethnicity concerned with what we call ‘second-order minorities’. If secessionist conflicts involve minorities resisting abusive, assimilationist states, leading rebel groups to embark on their own nation-building efforts, how does this affect the minorities of aspiring secessionist nations? How do the minorities of secessionist groups respond to secessionism? Despite many insightful studies of secessionism and rebel ethno-nationalism, scholars have yet to explore the ways that local minorities navigate secessionist conflicts. We suggest that the relationship between secessionists and second-order minorities depends on three key factors: whether minorities are territorially concentrated or dispersed, indigenous or migrant, and nation majorities or small national minorities. These characteristics provide us some idea of the types of violence and counter-mobilization we might see among second-order minorities faced with secessionist violence. This article then previews the subsequent studies of Xinjiang, Aceh, Mindanao, and Sri Lanka, cases which capture some of the core challenges faced by second-order minorities against twin violent nation-building efforts from state and rebel forces.     

Developing a manualized couples treatment for domestic violence: overcoming challenges

This paper describes challenges faced in a four-year project to develop a manualized couples treatment program for domestic violence. The couples treatment program is an add-on to a male batterer program where the male partner has perpetrated mild-to-moderate violence, yet both partners want to remain together. The project involved the cooperation of a variety of community agencies and referrals from key domestic violence programs. While some anticipated challenges did not materialize over the course of the project, unanticipated challenges did. Qualitative data collected from therapists and clients throughout the project was used to refine the treatment approach.     

Psychiatric nursing in the 1990s & beyond.

In the decade of the '90s, psychiatric mental health nursing will need to take stock of itself--its practice, its education, and its research--if it is to successfully prepare for the changes in care of the mentally ill. Like psychiatrists, we will need to rethink our agendas in light of new science and technology and rationalize the mental health delivery system and our role in it through systematic research and advocate for a system that provides quality care for the chronically ill and the poor. In the next century, we will need to rethink the basics of nursing care and the leadership roles of nurses as hospitals and the doctor's role within them changes. Psychiatric mental health nurses will need to be at the forefront in advocating for a delivery system that listens to patients and families, that humanizes the dehumanizing experience of hospitalization. The challenges before us are formidable.     

Recruitment & retention. A successful model in forensic psychiatric nursing

1. The recruitment and retention of forensic psychiatric nurses in this highly competitive environment has been identified as a critical issue. 2. In response to the need to expand services, the development, implementation, and evaluation of an innovative model that has demonstrated success in the recruitment and retention of nurses for this highly specialized area of practice are described. 3. The successful recruitment and retention of forensic psychiatric nurses may be facilitated by developing and implementing strategies that integrate the goals and objectives of the organization with the needs of individual nurses.     

Domestic Violence

ABSTRACT

As our communities and families are faced with the growing problem of violence, more information is needed as to what women in abusive relationships see as challenges that prevent or delay leaving. To address the issue in the brief therapeutic environment, 14 women in counseling for abuse agreed to participate in three task groups and were asked to identify and rank-order the challenges they faced that could prevent them from leaving. Group one included women who had a desire to leave but were not sure they could. Group two consisted of women working on a case plan but who still had concerns; and, the third group contained women who had left the relationship and were expecting not to return. Overall, when analyzing and comparing these groups, all women (regardless of the stage of leaving) expressed similar challenges and concerns. Major themes presented in all groups included: limited resources (e.g., money, shelter, day-care and medical expenses), fears (e.g., fear of being killed, retaliation, being alone, making the wrong choices, the unknown), commitment to the relationship, concern for children, love for the abuser and other emotional issues. These challenges are discussed and specific applications to facilitate practice are made.     

A gender-based incidence study of workplace violence in psychiatric and forensic settings

Limited data exist analyzing the role of gender in workplace violence in health care settings. This study examined whether different types of threatening incidents with patients (physical, verbal, sexual, or posturing) were salient to male versus female staff across psychiatric settings (inpatient forensic, inpatient acute/chronic psychiatric, and outpatient psychiatric). Results indicated that although women disproportionately experienced sexualized threats, they were not more likely to report such incidents as salient and threatening. The study also assessed the extent to which situational variables contributed to staff's feelings of threat. Results showed that rapport with the patient, quality of relationships with coworkers, and presence of coworkers in the area were not significantly related to how threatened staff felt in a recent threatening incident. Findings are discussed within the context of staff training and organizational benefits.     

VALUES IN CONFLICT: CHALLENGES TO FAMILY THERAPISTS' THINKING

Our familiar and comfortable family therapy theories were not designed to deal with violence and may help maintain our collective avoidance. Our formulations appear to make violence more manageable than it is and demonstrate our naivete. The limitations of therapeutic neutrality are explored as are the dangers inherent in some of our interventions. Effective amelioration of family violence requires linkages to larger systems.-Editor.     

Re-visioning nurses' punitive attitudes within forensic psychiatric and correctional nursing: the significance of ethical sophistication

1. Development is an essential lifelong process if we are to compassionately care for patients in forensic and correctional nursing. 2. Many of us are blocked in our ability to understand and to care; we will need to grow to meet the challenges and to bear the shocks of forensic and correctional nursing. 3. Concepts that correspond to Kegan's levels of consciousness imply a progression from punitive attitudes toward more positive attitudes.     

Using feminist ‘reflexive practice’ to explore stress and well-being of local researchers in South Sudan

ABSTRACT

This article discusses using feminist methods of reflexive practice to support and learn about the well-being of researchers working on gender-based violence research in South Sudan. In particular, we focus on the experiences of South Sudanese researchers undertaking this research in their own country. We share key findings and offer personal reflections on and suggestions for improving fieldwork. As feminists ourselves we placed a high value on sharing personal reflections on emotional challenges that the research team faced. However, our South Sudanese colleagues did not find these approaches very useful, preferring to discuss technical challenges, and placed emphasis on the importance of professionalism. This experience suggests the need for more culturally diverse feminist research tools, and for better recognition of the crucial role played by national researchers in international research projects. We end with recommendations.     

Are nonprofit prisons an alternative? Some experiences in the Netherlands

Outsourcing of detention is complex due to quality risks from incomplete contracts, the public responsibility for sentencing and execution, and related social opinions. In the Netherlands, prison services are extensively outsourced—particularly for juvenile detention and internal forensic psychiatric care—to nonprofit organizations. In the Dutch experience, we have not found differences between public and nonprofit execution with respect to the type of contract, costs, performance indicators such as escapes and violence against personnel. The Dutch experience shows that outsourcing to nonprofit organizations can be an alternative to outsourcing to private entrepreneurs.     

Christian Aid and LGBTI rights: breaking the silence

In recent years Christian Aid has begun to explicitly recognise and respond to discrimination faced by LGBTI people globally. A catalyst for this shift was the re-criminalisation of homosexuality in Uganda, Nigeria, and India in 2014, as well as partner reports of rising violence towards LGBTI people in Latin America and the Caribbean. However, breaking the silence on LGBTI issues within the organisation came predominantly through the emergence of an informal staff sexuality network. This article offers a critique of Christian Aid’s journey from being initially hesitant to engage with issues of LGBTI discrimination to recognising that as a faith-based development agency it can no longer remain silent. Taking such steps, however, has not been without challenges or risks.     

Relational ethics in forensic psychiatric settings

1. The pressure of the competing demands of custody and caring shapes the moral climate of forensic settings. 2. A relational approach to health care ethics, requiring the opening of dialogue, consideration of multiple perspectives, and attention to context, can guide nurses as they strive to engage and respect even their most estranged patients. 3. The core elements of relational ethics include mutual respect, engagement, and attention to the environment.     

Working with Stories: Street-Level Bureaucrats and Their Work with Individuals with Psychiatric Disability Exposed to Interpersonal Violence

ABSTRACT

The focus of our attention is the meeting between street-level bureaucrats and individuals with psychiatric disability exposed to interpersonal violence. Based on 11 interviews, we illustrate how stories are understood, used, and made meaningful to the street-level bureaucrat. The contribution of this article is first of all that of being a framework, from a storytelling point of view, for the work and organizational experiences of street-level bureaucrats. Second, by paying attention to the story part of these relationships, we can better understand the situation of individuals with psychiatric disability exposed to interpersonal violence given their interaction with different street-level bureaucrats.     

Good & evil in the crusade of care. Social constructions of mental disorders.

Forensic nursing is a product of medicalized criminality, where social and moral issues are managed within a psychiatric ideology. The narrative accounts of nursing staff reflect a tension between scientific and lay interpretations of offending behavior. A nonprofessional discourse about "evil" presents a challenge to the structural and clinical credibility of forensic practice.     

NEIGHBORHOOD DISADVANTAGE, SOCIAL CAPITAL, STREET CONTEXT, AND YOUTH VIOLENCE

This article integrates arguments from three perspectives on the relationship between communities and crime—constrained residential choices, social capital, and street context perspectives—to specify a conceptual model of community disadvantage and the violence of individual adolescents. Specifically, we propose that status characteristics (e.g., race, poverty, female headship) restrict the residential choices of families. Residence in extremely disadvantaged communities, in turn, increases the chances of violent behavior by youths by influencing the development and maintenance of community and family social capital, and by influencing the chances that youths are exposed to a criminogenic street context. We assess our conceptual model using community contextual and individual-level data from the National Longitudinal Study of Adolescent Health. Our findings suggest that individual or family status characteristics influence violence largely because of the communities in which disadvantaged persons and families reside. Although we find that community social capital does not predict individual violence, both family social capital and measures of an alternative street milieu are strong predictors of individual violence. Moreover, our street context variables appear to be more important than the social capital variables in explaining how community disadvantage affects violence.     

Striving to be ‘good’ mothers: abused women's experiences of mothering

So far, limited work has focused on women's experiences of mothering in the context of domestic violence. This article presents the findings of a study that investigated women's experiences of mothering in the context of domestic violence and, while it accounts for the difficulties and challenges these women face, it emphasises their desire to be ‘good’ mothers and the strategies they develop in order to achieve ‘good’ mothering. The findings demonstrate that abused women typically strive to be ‘good’ mothers, which requires them to put their children first and to protect and care for them. The recognition of these strategies provides ground to question current professional practices and to develop interventions that will best support women and children living with domestic violence. Copyright © 2010 John Wiley & Sons, Ltd.     

The collective approach to psychiatric practice in the People's Republic of China

This paper describes and analyzes the effects of the dramatic changes of social values in China on the approach to treatment of the mentally ill since the 1949 revolution. It is mainly based on observations, interviews, and experiences in mental hospitals during three recent trips to the People's Republic of China. Attention here is focused on the effects of four new social values on psychiatric practice: first, the value of collective responsibility as reflected in the new program to integrate mental hospitals with the community; second, the application of the value of sharing and "serving the people" to methods of psychiatric therapy; third, the value of "minimization of elitism" as practiced in the role relationships among members of different categories in mental hospitals; and fourth, the reaffirmation of faith in human ability to conquer difficulties, as shown in changes of patients' outlook on life and behavior. Finally, the implications of this alternative approach on our established assumptions and methods of psychiatric therapy in the West are discussed, and the future direction of theoretical formulation is suggested.     

Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.     

Sex,Drugs, Rock ‘n’ Roll…and Children

Abstract

In this article we identify some of the challenges for gay men who desire to create more intimate relationships and more stable families in the evolving and potentially more conducive socio-political environment of the 21st century in the United States. Secondly, we delineate a multi-systemic structural model of working with male couples and families that addresses the interplay of the couple's interactional system with larger religious, civil and social systems. Finally, we demonstrate systemic interventions with a case example of a male couple and their family coping with 21st century challenges.