Family Therapy in a Psychiatric Hospital: A Case-Controlled Evaluation

Thirty-five patients (20 women) treated by a Family Therapy Unit based in a psychiatric hospital were compared with 35 matched control inpatients who were not treated by the Unit. Family Therapy averaged 4.5 one hour sessions and was cybernetic rather than behavioural or psychoeducational. The main outcome measure was days spent in the hospital in the year after family therapy. Women, but not men, showed a significant improvement after family therapy, reducing their days in hospital from a mean of 50 in the year before family therapy to 18 in the year after. The best response was shown by women with affective disorder. Control men and women showed a slight increase in days spent in hospital. Improvement after family therapy was associated with a markedly positive change in key relatives' attitudes to the patient, and a strongly positive attitude towards family therapy.     

The Use of Chemical Restraints for Older Long-Term Hospital Patients: A Case Report from Finland

The purpose of this study was to describe the use and concomitant use of psychotropics and other drugs as chemical restraints in the aged in long-term hospital care. The study consisted of 154 patients (42 men, 112 women) hospitalized in five long-term care wards in Pori City Hospital, Finland. Three or more psychotropics were regularly given to 33% of the patients and regularly or irregularly to 53% of the patients. Two or more benzodiazepine derivatives or related drugs were regularly given to 24% of the patients and regularly or irregularly to 46% of the patients. The very poor cognitive and functional abilities of the patients, the common concomitant use of psychotropic drugs, the use of psychotropics to control the behavior of the patients, and the lack of documentation of the effects and side effects of the drugs give rise to the conclusion that psychotropics were used as chemical restraints in these long-term care wards.     

Sponsorship of Relatives for Migration and Immigrant Settlement Intention

The paper examines how important family reunification is in immigrants' decision to settle permanently in their country of destination. Using longitudinal data for a cohort of recent immigrants to Australia, it examines whether migrants' permanent settlement intention reported soon after arrival is related to their family sponsorship patterns and intention to sponsor, and whether family sponsorship patterns and intention in turn have an effect on immigrants' permanent settlement/return migration decision. The results show that a significant relation exists between sponsorship of close family members for migration and immigrants' permanent settlement intention and that the relation is particularly strong among skilled migrants. The study demonstrates the importance of kinship ties in permanent settlement and return migration decisions and suggests that liberal policies on family reunion migration may minimize settle loss, especially among skilled immigrants.     

The Integration of Interstate Migrants in India: A 7 State Policy Evaluation

Interstate migration in developing countries is a key income generating strategy for low-income households. In India, despite the importance of migration between states, interstate migrants continue to face significant integration barriers in their destination states. The impact of state borders on migration within India is significant and large. This study presents one of the first attempts at creating a set of indicators to understand the role of state-level policies for the integration of interstate migrants in a developing country. After illustrating the process behind the creation of this tool and the tool in itself, we compare seven of the major migrant destination states of India, based on their policy frameworks relevant to the integration of interstate migrants. Out of these states, we found that Kerala state is the most inclusive of interstate migrants but that overall, policymakers in the considered Indian states have a long way to go to improve the integration of interstate migrants.     

Evaluation of a Seven State Criminal History Screening Pilot Program for Long-Term Care Workers

This article summarizes results from an evaluation of a federally sponsored criminal history screening (CHS) pilot program to improve screening for workers in long-term care settings. The evaluation addressed eight key issues specified through enabling legislation, including efficiency, costs, and outcomes of screening procedures. Of the 204,339 completed screenings, 3.7% were disqualified due to criminal history, and 18.8% were withdrawn prior to completion for reasons that may include relevant criminal history. Lessons learned from the pilot program experiences may inform a new national background check demonstration program.     

Family Experiences of Caring for Relatives Who Have Received Electroconvulsive Therapy (ECT)

The research literature on family members’ experiences of the use of electroconvulsive therapy (ECT) is limited. This article explores the perspectives of family members whose relatives had received ECT. Drawing on a social constructionist perspective, this qualitative study collected data using in-depth interviews with nine families in South Australia, to examine how family members constructed the supports and challenges they experienced. The research found that families experienced a range of social and service system barriers, including social stigma and isolation, and limited support from health professionals. They had to negotiate caring expectations within a social context that stigmatised both mental illness and ECT. A need for ECT-specific mental health support groups was identified.

IMPLICATIONS

• Social workers’ roles in Australian hospitals could be further expanded to accommodate supporting families whose relatives have received ECT, referring families to community support, and advocating for specialist support post-ECT treatment.

• Social workers can further articulate their unique contribution to community care post-ECT treatment and advocate for supporting families.

• Increased focus on ongoing and preventative care for supporting families is a potential growth area for social workers in mental health.

     

“Family Matters”: A Systematic Review of the Evidence For Family Psychoeducation For Major Depressive Disorder

The first aim of this systematic review was to evaluate the evidence for family psychoeducation (FPE) interventions for major depressive disorder (MDD). A second aim was to compare the efficacy of different modes of delivering face‐to‐face FPE interventions. Ten studies (based on nine distinct samples) were identified comprising four single‐family studies, four multifamily studies, one single versus multifamily comparative study, and one peer‐led, mixed‐diagnosis study. Seven studies measured patient functioning and six reported positive outcomes. Six studies measured carer's well‐being and four reported positive outcomes. Results provide preliminary evidence that FPE leads to improved outcomes for patient functioning and family–carer's well‐being for persons with depression. The implications for future development and delivery of FPE interventions for MDD are discussed.     

Using Visual Art Workshops with Female Survivors of Domestic Violence in Portugal and England: A Comparative Reflection

ABSTRACT

This paper provides a reflection on the use of visual art workshops in an interdisciplinary feminist project with female survivors of domestic violence living in refuges in England and Portugal. The paper discusses the fieldwork in each location with attention to the interaction between participants, between participants and the researcher/s, and the cultural and institutional structures influencing the research and the images produced. Despite some key differences in the context, the analysis highlights key resonances and commonalities amongst the objects that survivors of domestic abuse depicted in each location. We use the feminist notion of ‘giving voice’ as an analytical tool throughout the paper. The paper argues that ‘giving voice’ was not unproblematically accomplished by using visual methods and suggests that our understanding remained partial and often reliant on verbal narratives accompanying the visual images produced. We also highlight issues of power emerging when exhibiting art generated through the study.     

Hospital response to the legalization of abortion in New York State: an analysis of program innovation

The reorientation of hospital services in the state of New York to accommodate women's constitutional right to elective abortion was investigated. Market and resource constraints, the social orientations of the organization, and the values of physicians were examined in the effort to evaluate hospital response between 1971 and 1973. Analysis indicates that program innovation in obstetrical and gynecological services to include elective abortion was inhibited by economic factors that generally determined the feasibility of diverting finite resources to a new service and social orientations and values that determined the compatibility of elective abortions with the dominant values underlying hospital operations. The reform of New York abortion statutes and the subsequent ruling by the Supreme Court reiterating the right of women to terminate pregnancy failed to standardize the delivery of health care so that individual rights to service could be obtained everywhere in the state. The social changes ultimately realized through legislative and judicial action were essentially conditional upon the responsiveness of local health care providers. Legal action that failed to specifically address the administrative role of hospitals in social change qualified local access and could not be completely effective in legitimizing the redefinition of abortion in society.     

Twelve-Step Facilitated Versus Mapping-Enhanced Cognitive-Behavioral Therapy for Pathological Gambling: A Controlled Study

This study examined the efficacy of two group treatments for pathological gambling, a node-link mapping-enhanced cognitive-behavioral group therapy (CBGT-mapping) and twelve-step facilitated (TSF) group treatment. Forty-nine participants meeting criteria for pathological gambling were recruited from local newspaper advertisements. These participants were randomly assigned to one of three conditions: TSF (n = 11), CBGT-mapping (n = 18), and Wait-List control (n = 9); 11 refused treatment prior to randomization. Outcome measures included number of DSM-IV criteria met, perception of control/self-efficacy, desire to gamble, and frequency of gambling episodes. Analyses revealed a significant treatment group × time interaction (η2_partial = .39). Specifically, the group treatments resulted in significant improvements in the dependent measures, while the Wait-List group remained relatively stable. Overall, CBGT-mapping and TSF had no significant differences on any outcome measure at follow-up assessments. Analysis of post-treatment and 6-month follow-up reveal a significant improvement in gambling outcomes (i.e., fewer DSM-IV criteria met, greater self-efficacy, and fewer gambling episodes (η2_partial = .35), with treatment gains maintained at 6 months. These results are consistent with previous research for group treatment for pathological gambling and provide support for the utility of TSF and a mapping-based CBT therapy as viable intervention for pathological gambling.     

A Global View of Changing State and Family Support for Older Persons

No abstract available for this article.     

A Randomized Controlled Trial of a Financial Literacy Curriculum for Survivors of Intimate Partner Violence

Financial literacy programs are quickly gaining in popularity around the globe. A relatively new target group is survivors of intimate partner violence (IPV), an economically vulnerable group for whom resource acquisition is related to personal safety and well-being. This study is a randomized controlled trial of a financial literacy curriculum designed for and delivered to a sample of 300 IPV survivors from 14 agencies in seven US states and Puerto Rico. Findings, based on difference-in-difference analyses and OLS regression models, indicate a strong effect of the curriculum on self-reported financial knowledge and behaviors and support the expansion of similar programs for survivors.     

Treatment Goal Selection for Female Pathological Gambling: A Comparison of Abstinence and Controlled Gambling

The current study was an exploratory investigation of the selection of controlled gambling as a goal of treatment for female pathological gambling. Specifically, it aimed to explore: 1) the popularity of controlled gambling as a goal of treatment; 2) the reasons pathological gamblers select abstinence and controlled gambling as goals of treatment; and 3) the characteristics of pathological gamblers attracted to abstinence and controlled gambling. The sample comprised 85 female pathological gamblers attending a cognitive-behavioural treatment program for pathological gambling. The selection of controlled gambling by one-third (34%) of the sample suggests that, at least in the Australian context, controlled gambling is a relatively popular goal of treatment for female pathological gamblers. In this study, the only differences between treatment-seeking female pathological gamblers selecting abstinence and controlled gambling were that those selecting controlled gambling were older and were less likely to endorse the belief that problematic gambling is a disease or affliction that can only be overcome by lifelong abstinence. Further research investigating the characteristics of pathological gamblers associated with controlled gambling as both a goal and outcome of treatment is required in order to ensure that treatment-seeking pathological gamblers can make an informed decision regarding their goal selection.     

Minimal Treatment Approaches for Concerned Significant Others of Problem Gamblers: A Randomized Controlled Trial

The goal of this study was to examine the efficacy of minimal treatment interventions for concerned significant others (CSOs) of problem gamblers. One hundred and eighty-six participants (82% females, 56% spouses) were randomly assigned to one of three groups: the first minimal intervention group received a self-help workbook [based on behavioral principles, modified from the Community Reinforcement and Family Therapy (CRAFT) model] and the second minimal intervention group received the workbook plus telephone support. The control condition received a treatment resource information package. Overall, all participants reported significant improvement in personal and relationship functioning and gambling behavior and consequences at the 3- and 6-month follow-up. The data demonstrated differences in favor of the interventions in three areas: days gambling, satisfaction with the program, and number who had their needs met. There was no difference in the number who had entered treatment. It may be that CSOs require more guidance and follow-up support to achieve these goals using the CRAFT procedures and strategies.     

The Current State of Evaluation Practices in Employee Assistance Programs,San Francisco

This study assessed the current state of evaluation practices within Employee Assistance Programs (EAPs). Because of structural variation and previous design problems, an examination of EAPs was needed. The sample consisted of 34 EAPs, primarily drawn from the San Francisco ALMACA chapter. A Program Survey was sent to each EAP, which included a demographics and an evaluation section. This study found that 59% of the sample reported conducting program evaluation and another 20% planned future evaluations. The findings of this study suggest a trend toward an increasing awareness of the value of EAP evaluation; however, important issues still need to be addressed.     

A Preliminary Investigation of Abstinence and Controlled Gambling as Self-Selected Goals of Treatment for Female Pathological Gambling

The current study aimed to provide a preliminary evaluation of the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered with the goals of abstinence or controlled gambling. The findings were based on the comparison of pathological gamblers selecting abstinence and pathological gamblers selecting controlled gambling on measures of gambling behaviour and psychological functioning. The findings revealed that pathological gamblers selecting controlled gambling displayed comparable levels of improvement to those displayed by gamblers selecting abstinence. Using a treatment completer approach, 89% of the gamblers selecting abstinence compared with 82% selecting controlled gambling no longer satisfied the diagnostic criteria for pathological gambling by the completion of the 6-month follow-up period. Although further scientific demonstration is required, the findings of this study provide preliminary support for the practice of offering controlled gambling as an alternative goal in the treatment of pathological gambling.     

Career Development for At-Risk Youth: A Program Evaluation

At-risk populations pose a major challenge to the counseling profession. This article describes a career development program for at-risk youth and delineates both the process and the outcomes of a combined quantitative and qualitative program evaluation. The results suggest that at-risk youth can benefit significantly from this career development program. A combination of work and curricular experiences seemed to be effective with this population.