Integration of Information Technology and Single-System Designs

This paper employs a model of innovation diffusion to examine current issues and concerns related to the use of single-system design and its relationship to information technology. The paper will review emerging work in the area of single-system methodology and information technology, and suggest future directions on how the integration of the two innovations might benefit practitioners and clients in the human services.     

A Research Odyssey

This second special issue on single-system designs begins with an essay celebrating the life and work of Ludwig L. Geismar, who contributions to social work research include penetrating investigations on poverty, the multi-problem family, delinquency, and child-care. For nearly forty years, he has blended theory, research, and practice with persistent energy and vitality, and has set an important benchmark in social work scholarship. It is important that social work researchers know from whence we began so as to understand where we are now and where we are likely to be headed. This essay honors one of the significant contributors to that understanding: Ludwig L. Geismar.     

Use of Single-System Research to Evaluate the Effectiveness of Cognitive-Behavioural Treatment of Schizophrenia

Correspondence to William Bradshaw, Ph.D., LICSW School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Ave. St. Paul, Minnesota 55108, USA. E-mail: Bbradsha{at}che.umn.edu Summary Practitioner research that utilizes single-system designs andreplication studies has been promoted as a means to developpsychosocial interventions of demonstrated effectiveness. Atthe same time, there has been relatively little practitionerpublication of single-system studies. The purpose of this studywas to evaluate the effectiveness of cognitive-behavioural interventionsin the treatment of schizophrenia. The study used a single-systemmultiple baseline design across seven subjects to evaluate changein clinical outcomes. The AB design included a (A) baselinephase and (B) cognitive-behavioural intervention phase. Standardizedmeasures of psychosocial functioning, severity of symptoms andattainment of treatment goals were used to assess change overthe course of three years treatment. A pre-test/post-test designwas used to measure achievement of treatment goals. All sevenclients made statistically significant improvement in psychosocialfunctioning when the baseline mean was compared to the interventionmean. The average effect size for the seven cases was 2.96.All seven clients made a statistically significant reductionin severity of psychiatric symptoms when the baseline mean wascompared to the intervention mean. The average effect size forthe seven cases was -2.19. All seven clients exceeded the expectedlevel of attainment of treatment goals. The pre-test averagegoal attainment score for the seven cases was 20.65 (sd = .55).The average post-test score was 71 (sd = 8). Directions forfuture research and the applicability of single-system designsfor the practitioner researcher evaluation of mental healthpractice are discussed.     

The ‘virtuous’ cycle of parental empowerment: Partnering with parents to safeguard young people from exploitation

When young people are sexually exploited, parents and professionals alike can feel uncertain about how to balance the need to protect the child's rights to agency and autonomy while also reducing the risk of harm. Despite the shared interest in keeping young people safe, there remains a substantial gap in the research literature about how practitioners engage parents to increase capacity to safeguard their children, particularly within the context of a child protection system ill-equipped to address forms of extrafamilial harm such as child sexual exploitation. This paper aims to contribute to understanding how professionals effectively engage parents by drawing upon evidence from research evaluations of two programmes in rural/urban North and urban South locations in England, both providing specialist support to parents/carers of sexually exploited children and young people. Through interrogating elements of effective support work evidenced across both programmes, a set of emerging key themes are presented, proposing that parent support and engagement can create a ‘virtuous’ cycle, whereby families are strengthened and are better able to protect their children from sexual exploitation and other forms of extrafamilial harm.     

论共同危险行为的免责事由——对《侵权责任法》第10条的学理性解读

二人以上共同实施危及他人权益的行为并造成损害后果,但不能确定具体加害人的情况下,危险行为人能否通过证明自己行为与损害结果没有因果关系而免责问题,我国学界存在着“肯定说”和“否定说”,尤其《侵权责任法》第10条的模糊性规定使得学界和实务界对于共同危险行为免责事由的认识更加混乱;将“不能确定具体侵权人的,行为人承担连带责任”理解为共同危险行为制度的构成要件,而不是证明具体加害人的责任,或许是解决共同危险行为免责事由认定方面面临的现实尴尬的一种尝试性途径,但理想的方式仍是通过司法解释的模式明确《侵权责任法》关于共同危险行为免责事由的具体规定.     

The therapeutic misconception,beneficence, and respect

In order to provide benefits to society, human medical trials must place subjects at risk of harm. This activity is thought to be justified in part by the consent of the subjects involved. But, studies have shown that most such consents are based on a therapeutic misconception (TM); the false belief of subjects that their researchers will act as their personal physicians (seeking their benefit and protecting them from harm), rather than placing them at risk of harm for the good of others. Toleration by researchers of the TM in their subjects is a form of "informational manipulation" that renders consent procedures disrespectful to subject autonomy. Consent obtained from subjects who labor under a TM is neither voluntary nor informed; as long as they have not been disabused of the TM, the action they take in enrolling in a trial is not the one they intend nor is it autonomously chosen. Changes in consent procedures should be adopted to ensure that all subjects are aware inter alia that (a) the health interests of future patients (as well as the researchers' and their sponsors' financial interests) may be more important to researchers than the interest of a subject in his or her health, and (b) normal subjects neither understand nor believe this when told. Close attention to the response of prospective subjects to this information should allow for the exclusion of all but the truly altruistic. However, the result of conscientious implementation of such policies would likely be that human medical research could no longer be conducted on more than a minimal level.     

Disclosure of individualized research results: a precautionary approach

Assessing and managing risks to participants is a central point of contention in the debate about disclosing individualized research results. Those who favor disclosure of only clinically significant results think that disclosing clinically insignificant results is risky and costly, and that harm prevention should take precedence over other ethical considerations. Those who favor giving participants the option of full disclosure regard these risks as insubstantial, and think that obligations to benefit participants and promote their autonomy and right to know outweigh the obligation to prevent harm or financial considerations. The risks of disclosing clinically insignificant research results are currently not quantifiable, due to lack of empirical data. The precautionary principle provides some insight into this debate because it applies to decision-making concerning risks that are plausible but not quantifiable. A precautionary approach would favor full disclosure of individualized results with appropriate safeguards to prevent, minimize, or mitigate risks to participants, such as: validating testing methods; informing participants about their options for receiving tests results and the potential benefits and risks related to receiving results; assessing participants' comfort with handling uncertainty; providing counseling and advice to participants; following-up with individuals who receive tests results; and forming community advisory boards to help investigators deal with issues related to disclosure.     

Disclosure of Individualized Research Results: A Precautionary Approach

Assessing and managing risks to participants is a central point of contention in the debate about disclosing individualized research results. Those who favor disclosure of only clinically significant results think that disclosing clinically insignificant results is risky and costly, and that harm prevention should take precedence over other ethical considerations. Those who favor giving participants the option of full disclosure regard these risks as insubstantial, and think that obligations to benefit participants and promote their autonomy and right to know outweigh the obligation to prevent harm or financial considerations. The risks of disclosing clinically insignificant research results are currently not quantifiable, due to lack of empirical data. The precautionary principle provides some insight into this debate because it applies to decision-making concerning risks that are plausible but not quantifiable. A precautionary approach would favor full disclosure of individualized results with appropriate safeguards to prevent, minimize, or mitigate risks to participants, such as: validating testing methods; informing participants about their options for receiving tests results and the potential benefits and risks related to receiving results; assessing participants' comfort with handling uncertainty; providing counseling and advice to participants; following-up with individuals who receive tests results; and forming community advisory boards to help investigators deal with issues related to disclosure.     

Equipping child protection practitioners to intervene to protect children from cumulative harm: legislation and policy in Victoria,Australia

Many children are repeatedly reported to statutory child protection services, but do not receive the protection they need. Many such children are suffering chronic maltreatment, which is likely to result in cumulative harm. Chronic maltreatment encompasses emotional abuse and chronic neglect. As a result, children can experience a range of cognitive, emotional, and behavioural problems that are more serious than those associated with other abuse types. This paper focuses on the Victorian statutory child protection system, and considers why cumulative harm is not receiving the attention the legislation intends. Under the Victorian legislation cumulative harm must be proven on grounds of emotional abuse and/or neglect. However, it is difficult for child protection practitioners to place before the court the necessary evidence to establish these grounds. The paper concludes that the legal definitions of emotional abuse and neglect should not require evidence of a link between the abusive actions of the parent and the poor outcomes for the child. The evidentiary focus should be on the actions of the parent. Furthermore, legislation should focus on abusive parental behaviours that are likely to result in cumulative harm, which are more concrete and measureable than emotional abuse and neglect, such as intimate partner violence and parental illicit drug use.     

Combining the Single-System and Group Approaches to Evaluate Treatment Effectiveness on the Agency Level

This paper suggests the integration of single-system and group comparison approaches in evaluating treatment effectiveness of service agencies. The basic building blocks of the advocated methodology are single-case evaluations which are intentionally designed, selected and aggregated to form an assessment on the agency level. For each intervention, data on the characteristics of treatment, therapist, problem and client are collected and correlated with outcome measures to identify differential effectiveness. The paper reports on an assessment project which utilized this approach to evaluate task-oriented family interventions. The potential benefits of this methodology are discussed.     

Bathing and the Politics of Care

Though providing baths in the community for disabled and older people has long been an area of service dispute, it has received little academic or policy attention. This is partly because bathing and washing are assumed to be common-sense activities. This paper suggests instead that washing and bathing are far from straightforward or common-sense and that specific meanings attach to them in ways that affect how people experience the receiving of help in these areas. It explores the history of bathing and washing and the significance of touch and nakedness in service provision. It then turns to the service providers who have traditionally undertaken such work—the community nursing and home care services—exploring the rationales that underlie such patterns and the implications of current changes in community care.     

Choosing hunger

In much of the academic literature, hunger is treated as a problematic condition that affects people against their will. However, this focus ignores the many instances in which people actively choose to go hungry. The clearest examples are cases – such as dieters, hunger artists, and religious fasters – in which the choice seems voluntary. Yet people forced into famine or starved in concentration camps also make critical, though often subtle trade-offs related to hunger. This paper explores two fundamental characteristics that help to clarify the differences between various cases of hunger: the degree of choice and the severity of the consequences. By emphasizing the centrality of choice and providing a framework for the analysis of various situations, the paper argues for a re-examination of the concept of hunger.     

Unemployment and Labour Market Policies: Some Lessons from West Germany

The author points out that West Germany has had low inflation, high industrial efficiency, and good vocational training, but has not escaped rising levels of unemployment. After an analysis of employment trends in Germany since 1945 there is a review of varying government policies in public expenditure and in dealing with unemployment. The author relates demographic trends to employment patterns, and refers to such phenomena as the "dormant labour force", concluding that unemployment will remain high. He reviews the effects of social security benefits and of job creation schemes. He concludes that none of the well-known remedies for unemployment have proved effective in themselves but that short-term job creation schemes are very much a "second-best". He concludes that industrial efficiency — though essential — is not enough in itself and that conquering inflation or providing youth training are shown by the German example to be only a partial help and not a solution to improving employment prospects.     

The therapeutic misconception,beneficence, and respect

In order to provide benefits to society, human medical trials must place subjects at risk of harm. This activity is thought to be justified in part by the consent of the subjects involved. But, studies have shown that most such consents are based on a therapeutic misconception (TM); the false belief of subjects that their researchers will act as their personal physicians (seeking their benefit and protecting them from harm), rather than placing them at risk of harm for the good of others. Toleration by researchers of the TM in their subjects is a form of “informational manipulation”; that renders consent procedures disrespectful to subject autonomy. Consent obtained from subjects who labor under a TM is neither voluntary nor informed; as long as they have not been disabused of the TM, the action they take in enrolling in a trial is not the one they intend nor is it autonomously chosen. Changes in consent procedures should be adopted to ensure that all subjects are aware inter alia that (a) the health interests of future patients (as well as the researchers’ and their sponsors’ financial interests) may be more important to researchers than the interest of a subject in his or her health, and (b) normal subjects neither understand nor believe this when told. Close attention to the response of prospective subjects to this information should allow for the exclusion of all but the truly altruistic. However, the result of conscientious implementation of such policies would likely be that human medical research could no longer be conducted on more than a minimal level.     

The Psychology of Environmentally Sustainable Behavior: Fitting Together Pieces of the Puzzle

This paper considers the main features of four general psychological approaches to the analysis of environmentally sustainable behavior (rational–economic, social dilemmas, attitude–behavior models, and applied behavioral analysis), and focuses on the problems inherent in applying each approach to this issue. It also details the utility of a holistic Social–Ecological Framework that I believe is useful for analyzing environmentally sustainable behavior. This approach draws on concepts from ecological psychology such as Gibson's (1979) notion of "affordances," and shows how such a method can account for and help us understand the limitations of traditional psychological approaches to environmentally sustainable behavior, and provides a general guiding framework for the formulation of environmental policy decisions and intervention programs.     

Are the poor worse at dealing with ambiguity?

This paper studies the relationship between people’s ambiguity attitudes and income in the field using language as a natural source of ambiguity. It shows that the method of Baillon et al. (2017b) can be adapted for field studies, providing ambiguity measurement tasks that are more comprehensible for nonacademic subjects. Ambiguity attitudes were elicited in two groups of Chinese adolescents (poor rural and rich urban), among whom the income variation is big. In the rural group the poorer are both more ambiguity averse and more a-insensitive, whereas in the urban group the richer are more a-insensitivite. On average, the poor rural adolescents are worse at dealing with ambiguity than their urban counterparts. A-insensitivity, which measures people’s understanding of an ambiguous situation, is an important but sometimes neglected component of ambiguity attitude. Policies aiming to help people improve decisions may focus more on reducing a-insensitivity as this cognitive bias is more likely to be influenced by intervention than people’s intrinsic aversion towards ambiguity.     

Social Network Analysis for Analyzing Groups as Complex Systems

ABSTRACT

The introduction and application of social network analysis, a method seen as superior to experimental or single-system research design for showing group change, examined group dynamics and change over time using a hypothetical example of an Internet group for gays and lesbians. Rather than utilizing traditional definitions of independent and dependent variables, the analysis utilized hypothetical data with nodes or individuals, ties, and the relationships they formed. The recently developed computer program NodeXL provided diagrams and statistics that demonstrated node and tie variation and individual and group development over time. Discussion demonstrated the utility of such diagrams for research and practice.     

Older Couples

This study examines the degree to which older, noninstitutionalized husbands and wives are involved in providing various types of assistance, the likelihood of providing assistance to one's spouse and to others, and the characteristics associated with giving more forms of help. The findings suggest that older wives are more likely than older husbands to provide most of these forms of assistance. Furthermore, husbands are more likely to help their spouses, while wives are more likely to report helping people outside the conjugal pair. Multiple regression analysis suggests that the ability of the potential recipient spouse to perform daily living tasks is a key factor in determining number of forms of help provided by the potential helping spouse.     

Single-Case Evaluation Designs for Practitioners

ABSTRACT

This article examines single-case designs that omit baseline phases, contain shorter reversal phases, administer treatment across fewer baselines, or have other features that make them easier for practitioners to use in evaluating their own interventions. Particular attention is given to the Repeated Pretest-Posttest and the Periodic Treatments Designs, the Nonconcurrent Multiple-Baseline Design, the short reversal design, the short multiple-baseline design, and the short alternating treatments design. Also discussed and illustrated is how these streamlined designs can raise practitioners' sensitivity to intervention outcomes, assist practitioners in providing evidence-based services while adjusting for client diversity, and advance practitioners' knowledge.     

司法过程中的利益衡量批判

在司法过程中,价值衡量是法官填补法律漏洞、作出正确裁判所必须依赖的重要方法。然而,长久以来,价值衡量被简化为利益衡量,并在许多法学论著中取得了支配地位。文章意在指出,这种简化实质上是一种将权利利益化的庸俗产物,它对于法治和司法正义必然产生损害,指出这一实质,并作出“权利论”的批判,有助于维护法治之真谛并在司法实践中推动它的实现。