Clinical Assessment of Canadian Military Marriages

This theoretical discussion shed lights on the elements that impact on Canadian military marriages. A case example is presented to illustrate the value of using the strengths perspective, systems theory and attachment theory when assessing couples in this group. It further demonstrates how different assessment approaches produce significantly varied treatment plans.     

The Use and Abuse of Models of Disability

Throughout history, theorists have made use of the technology of the day to provide explanatory models of the behaviour they observe in order to provide an improved understanding of human behaviour. Bax (1998) describes the use of models of disability as not particularly helpful in relation to the treatment of children with physical disabilities. It is the purpose of this paper to show that models do have their place within disability research and the implications of using the medical and social models of disability, together with two models from developmental psychology, namely the transactional model and systems theory, will be discussed. It is argued by the authors that the usage of these models can aid understanding of disability in both research and clinical settings.     

Empirically supported family-based treatments for conduct disorder and delinquency in adolescents

Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief strategic family therapy. In addition to summarizing the theoretical and clinical bases of these treatments, their results in efficacy and effectiveness trials are examined with particular emphasis on any demonstrated capacity to achieve favorable outcomes when implemented by real-world practitioners in community practice settings. Special attention is also devoted to research on purported mechanisms of change as well as the long-term sustainability of outcomes achieved by these treatment models. Importantly, we note that the developers of each of the models have developed quality assurance systems to support treatment fidelity and youth and family outcomes; and the developers have formed purveyor organizations to facilitate the large-scale transport of their respective treatments to community settings nationally and internationally.     

INFORMATION ACQUISITION UNDER RISKY CONDITIONS ACROSS REAL AND HYPOTHETICAL SETTINGS

I collect data on how subjects acquire information about risky choices in both real and hypothetical settings using process‐tracing software called Mouselab. On average, there are no significant differences across settings in the amount of time subjects take to make a choice or the completeness of the information they acquire. Subjects also acquire information in sequences consistent with an integration model of decision‐making, such as expected utility theory or prospect theory. I do not find significant differences in risk preferences across settings, on average, but I do find that subjects' risk preferences are related to the completeness of the information that they acquire and where they start their information acquisition. (JEL C91, D80, D83)     

Millennium Development Goals: Impact on national strategies and spending

This study reviews the post‐2005 national development strategies of 50 countries from diverse income groups, geographical locations, human development tiers and official development assistance (ODA) levels to assess Millennium Development Goal (MDG) absorption into development planning. Reviewing Poverty Reduction Strategy Papers (PRSPs) and non‐PRSP national strategies, the majority of the development plans have either adopted the MDGs as planning tools or ‘localized’ them in a meaningful way, using diverse adaptation strategies. A high correlation is detected between the income group, PRSP status and ODA reliance of countries, and their propensity to incorporate MDGs in their planning instruments. However, MDG alignment is not coterminous with greater pro‐poor or MDG‐oriented policies. Countries that have not integrated MDGs into their national plans were as likely to allocate government funds to social sectors as MDG aligners.     

Meaning of Political Controversy in the Classroom: A Dialogue Across The Podium

The abstract value of academic freedom is enjoyed (or not) in concrete settings, as interactional and emergent experiences. We examine classroom political controversy in our experiences, understandings, and values, using grounded theory methods and collective autoethnography by a team of five teachers and students. Our data were generated through electronic and face‐to‐face dialogues. Our analysis, guided by a symbolic interactionist and constructionist framework, yields a picture of Controversy in Action, whereby we navigate Barriers to Open Discussion and Costs of Controversy. Results highlight insights into taken‐for‐granted meanings unexamined in day‐to‐day classroom interaction. We attend to the relevance of the local context in which our classrooms are embedded and the interactional, meaning creating work that goes on in those classrooms, as we negotiate controversy.     

Autonomy in long‐term care: a need,a right or a luxury?

Doyal and Gough’s theory of human need highlighted that personal autonomy is a universal need and human right, essential for well‐being. In applying their theory to older disabled people in the UK the author suggests that their ‘minimally autonomous’ threshold would exclude some older people in long‐term care who still have a fundamental need for autonomy or, alternatively, extant autonomy. The disability movement has highlighted that independent living is fundamental to achieving self‐determination for disabled people and debate on equality and caregiving emphasises the autonomy of carers. However, there is a lack of recognition in both academic research and government policy of autonomy as a need and right of older disabled people. The author argues that autonomy is a human right of older people living in long‐term care settings, but that social rights are necessary to facilitate their autonomy.     

The Family Movement,Bowen Theory,and Theoretical Medicine: A View from the 21st Century

Important changes have occurred in the family movement in the United States since it emerged in the mid‐1950s. Psychiatry supported the movement in its early years, but that changed as psychiatry abandoned the biopsychosocial model and adopted the biological paradigm through the 1970s. This development pushed family and other therapies to the periphery of the discipline. Medicine is dominated by the biological paradigm and cause‐and‐effect thinking. The roots of the medical model go back to Pasteur. In contrast, psychiatry in the United States had been dominated through the 20^th century by psychoanalytic thinking, which rendered the discipline a step‐child to medicine. This and other factors pushed psychiatry to get biological. The change generated a ‘failure of nerve’ in the family movement, abandoning the role of the family in schizophrenia in the face of psychiatry's assertion that all serious mental illnesses had nothing to do with the family. Other important changes separating the family movement from psychiatry occurred as well. Bowen theory is anchored in biology and evolution, but it is not a biological paradigm. Maintaining solid connections to the scientific disciplines are important for keeping the theory an open system. The recent emergence of systems biology and systems medicine could challenge psychiatry's allegiance to the biological paradigm and bring family systems theory centre stage in the discipline. These new disciplines may also arrive at a systems theory of the individual that can be integrated with family theory, powering a paradigm shift in medicine as a whole.     

Primary healthcare planning,bottleneck analysis and performance improvement: An evaluation of processes and outcomes in a Nigerian context

Operational planning of interventions defines roadmaps, timelines and resources necessary for translating policies into expected health outcomes along the evidence-policy-implementation continuum. However, bottlenecks often hinder the attainment of objectives and the timely delivery of intervention packages leading to sub-optimal performance of health systems. Bottleneck identification, analysis and removal approaches to planning, which requires key stakeholders’ participation, have been recommended to improve health system outcomes in LMICs. This study demonstrates how integration of participatory action research (PAR) within a quality improvement model can help navigate the complexities of health system bottleneck analyses, planning and performance improvement in a Nigerian sub-national context.The study is based on data collected between June 2016 and June 2017, from Chikun LGA in Kaduna State Nigeria. PAR was integrated into a quality improvement model called DIVA (Diagnose-Intervene-Verify-Adjust) applied across selected interventions (eMTCT, Antenatal care, skilled birth attendance, immunization and Integrated Management of Childhood Illnesses). PAR was used to identify and analyse health system bottlenecks, as well as develop, monitor implementation and follow-up on action plans to address them. Evaluations were conducted involving 2 cycles of DIVA. The outputs (bottleneck analysis charts, driver diagrams, operational plans, M/E reports, etc.) from each cycle of the DIVA process were collated and analysed. Bottlenecks identified include availability of human resources for health, availability of health commodities as well as geographical accessibility. These had implications on acceptability and quality of services. Mean Improvements recorded were 20.4%, 14.0% and 10.8% and 11.2%, 7.5%; 5.5% (across eMTCT, maternal health and child health interventions) in the 1 st and 2nd DIVA cycles respectively. This study highlights processes and outcomes of integrating PAR in quality improvement design and operations in health intervention programmes with a focus on health systems strengthening in a Nigerian context. Implementing the DIVA model using a PAR approach may be considered an effective strategy for planning and implementing health interventions in comparable settings.     

COMPETITIVE FIRM BEHAVIOR UNDER RISK IN DISEQUILIBRIUM TRADING

The objective of this paper is to study the behavior of the purely competitive firm in a market in which traders' plans may not be realized each period. The emphasis of the study is motivated by a desire to introduce explicit price-makers into the theory of competitive markets. The method of introducing price-makers may lead to situations in which markets are not cleared each period and shortages may arise with the realization of plans being in doubt. In this environment traders learn to adjust decisions to offset periodic disappointment. Multiperiod models are introduced to analyze the decision process of the competitive firm in the market and stochastic dynamic programming methods are used to obtain characteristics of optimal plans. Results are compared to the situation in which plans are always realized.     

The Termination Stage in Bowen's Family Systems Theory

The termination stage has always been recognized as an important aspect of the clinical intervention process. Careful attention to that stage is even more critical in the current practice environment of short-term intervention and demands for measurable outcomes. Bowen's family systems theory, while well established in the field of clinical practice, does not incorporate clear directives for the practitioner about the ending stage of intervention. Still, its major concepts for assessment and intervention suggest a range of termination activities that can affirm and summarize a family's gains. In this article the authors offer a variety of ending strategies for use within family systems theory.     

The Atascadero State Hospital experience. Engaging patients in violence prevention.

When it comes to caring for the forensic psychiatric inpatient, there is no "how to" book. In the forensic hospital environment, the commingling of severe and persistent mental illness with criminality poses vexing clinical challenges and complex moral dilemmas not faced in either general psychiatric or correctional environments. While providing evaluation and treatment in our maximum security forensic environment, we continually strive to create and maintain a therapeutic milieu as we fulfill our social mandate to protect the public from the dangerous "criminally insane." Few studies guide us. We do know that within the forensic population there is a spectrum of psychopathology to manage, some of which responds to traditional psychotherapeutic techniques and some of which does not. For example, patients with psychopathic traits may not respond well to traditional treatment methods (Rice, 1997). As forensic psychiatric staff, we sometimes feel as if we are making it up as we go, adapting and blending psychiatric theory with knowledge from penology and criminal justice science to provide a safe environment conducive to growth for patients, the majority of whom may be considered "violence-prone" persons (Toch, 1969). Change is a characteristic of public-sector settings (Smoyak, 1991). Forensic hospitals must continually strive to monitor, refine, and improve their organizational systems as they respond and adapt to constant change. Despite the inherent challenges posed when collaborating with forensic patients, the VAC has achieved some notable successes. Staff and patients have been encouraged to work together to create and maintain a milieu where violence is neither assumed nor condoned. An active collaboration and partnership with our forensic patients has been one component of the hospital's successful violence reduction program. We trust that ASH's successful effort to collaborate with patients on the issue of violence reduction may be of use to other forensic hospitals faced with similar challenges.     

CONTEST DESIGN: AN EXPERIMENTAL INVESTIGATION

This paper experimentally compares the performance of four simultaneous lottery contests: a grand contest, two multiple prize settings (equal and unequal prizes), and a contest which consists of two subcontests. Consistent with the theory, the grand contest generates the highest effort levels among all simultaneous contests. In multi‐prize settings, equal prizes produce lower efforts than unequal prizes. The results also support the argument that joint contests generate higher efforts than an equivalent number of subcontests. Contrary to the theory, there is significant over‐dissipation. This over‐dissipation can be partially explained by strong endowment size effects. Subjects who receive higher endowments tend to over‐dissipate, whereas such over‐dissipation disappears when the endowments are lower. This behavior is consistent with the predictions of a quantal response equilibrium. We also find that less risk‐averse subjects over‐dissipate more. (JEL C72, C91, D72)     

Ethical Research Involving Children: Encouraging Reflexive Engagement in Research with Children and Young People

Research involving children raises complex and well‐documented ethical questions and challenges that extend far beyond the reach of formal review and governance systems, where these exist. However, researchers collectively have a wealth of knowledge and experience in applying universal ethical principles in diverse social, cultural and methodological settings, which offers much potential for understanding how ethical concerns are responded to in situ. Through extensive consultation and research, the Ethical Research Involving Children (ERIC) project, discussed in this article, has drawn on this collective knowledge in generating evidence‐based resources that highlight best practice while grounding ethical decision‐making in lived experience.     

Exploring changes in family functioning when a child participates in a School-Based Filial Therapy program

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child-focused processes, which undermine rather than enhance child well-being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child-focused. Bowen theory is the guiding theoretical framework for School-Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer-regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed-methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre- and post-data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child-focused processes remained dominant but changed in intensity and valence following SBFT.     

Steering the Poverty‐Environment Nexus in Central Asia: A metagovernance analysis of the Poverty‐Environment Initiative (PEI)

The close and reciprocal ties between poverty and environmental degradation present significant potential for simultaneous improvement of the livelihood of the poorest along with increased opportunities and enhanced resilience of the environment and natural resources. By supporting governments and other stakeholders in designing and implementing development plans that tackle environmental and poverty concerns in a joint manner, the globally operating UNDP‐UNEP Poverty‐Environment Initiative (PEI) addresses a major governance challenge for sustainable development (SD) and the Sustainable Development Goals (SDGs) in particular. Focusing on Central Asia, and specifically Tajikistan, a country outside the spotlight of studies concerned with SD governance mechanisms, and through the analysis of PEI programme documents and stakeholders’ interviews, this article probes into the governance and governance co‐ordination (metagovernance) settings for SD. The article closes by presenting a set of recommendations to improve governance co‐ordination, while achieving more inclusive decision‐making and ultimately increasing the impact of PEI on the society and the environment. Specifically, it argues for improved information policy and enhanced integration of endogenous knowledge. Furthermore, national and local development planning and private initiatives should be better linked, and the different levels of governance for poverty‐environment mainstreaming should be more coherent. The solutions discussed are of relevance for wider Central Asia and the global community engaged in moving the SDGs into the mainstream of governance and policy frameworks.     

A Client Perspective on Therapist Self-Disclosure

Abstract

Options of “coming out” in differing therapeutic modalities are considered. Modalities considered include traditional psychotherapy, alternative therapies, and managed care systems. Therapist disclosure situations are discussed from the viewpoint of both client and practitioner. Vignettes describing therapy experiences of adult lesbian and gay clients in a variety of clinical settings are presented. Clinical issues pertaining to therapist disclosure of sexual orientation receive consideration in terms of client self-determination as well as in terms of the options or limitations imposed by different modalities. Distinctions are drawn between disclosure in predominately lesbian and gay practice settings and disclosure in predominately heterosexual settings.     

Localized globalization: A multi‐local,multivariate investigation of quotative be like1

We conduct a multi‐local, multivariate analysis of be like in comparable datasets from three discontinuous geographic settings (the U.S.A., England, and New Zealand). Previously, comparative cross‐variety analysis of this form has been fundamentally hampered by key methodological differences. A methodologically coherent analysis reveals that the ‘classic factors’ ( Tagliamonte and D’Arcy 2007 : 203) grammatical person and content of the quote, as well as the effect of mimesis, are transferred to the receptor variety, albeit with varying degrees of completeness. Other conditioning factors are particularized to the local system into which be like is adopted, which leads us to define its spread as a case of weak transfer. We suggest that there are at least two explanations for this finding: (1) global innovations must be considered in light of the local systems into which they are adopted; and (2) the form and amount of contact must be correlated with respect to the knowledge transfer they allow.     

Whole Family Theraplay: Integrating Family Systems Theory and Theraplay to Treat Adoptive Families

This article regarding the effectiveness of Theraplay for the clinical treatment of adoptive families both outlines a model for integrating family systems theory with Theraplay to create a new approach entitled Whole Family Theraplay (WFT), as well as provides a preliminary report of a pilot study demonstrating the efficacy of that model. WFT integrates Theraplay with family systems approaches (Structural and Experiential Family Therapies) to treat parents and all the siblings within adoptive families. The findings indicate that WFT treatment may lead to statistically significant benefits in regard to family communication, adults’ interpersonal relationships, and children's overall behavioral functioning.     

Stability and Change in Female and Male Violence across Rural and Urban Counties, 1981–2006

Two durable criminological patterns have been higher violence rates in urban compared to rural areas and by males compared to females. To derive and evaluate hypotheses related to correspondence across place and sex groups in changes in violence trends, we draw on a spatial‐inequality perspective that attends to the geographic distribution of inequalities at the subnational scale, as well as to recent extensions of social‐disorganization theory to variation in rural and female violence rates. Our study's focus is on systematically delineating the extent and timing of change in female and male violence trends, the rural‐urban violence gap, and the gender gap. We apply epidemiological joinpoint techniques to Uniform Crime Reports arrest data from completely rural to highly urbanized settings for several violent offenses (homicide, robbery, aggravated assault, and misdemeanor assault) between 1981 and 2006. Female and male violence rates in rural to urban settings generally followed the same course over 25 years. Analyses generally indicated parallel violence trends of rural and urban females and males and only subtle changes in the rural‐urban and gender gaps in serious violence. Serious violence became somewhat less concentrated in urban centers owing to more sizable urban rate declines after the mid‐1990s. In all contexts, the gender gap in assault arrests narrowed, but the female share of serious violence (homicide, robbery) remained much the same; this result suggests change in the social control of minor violence by females across rural and urban settings.