New pathways in the evaluation of programmes for men who perpetrate violence against their female partners

Today, evaluation research in the field of intervention programmes for men who perpetrate violence against their female partners still makes a fragmentary impression. Across Europe various evaluation studies have been performed. However, the methodologies applied are too heterogeneous to allow the combination of the results in a meta-analytical way. In this paper we propose a future pathway for organising outcome evaluation studies of domestic violence perpetrator programmes in community settings, so that today’s problems in this field can be overcome. In a pragmatic framework that acknowledges the limited pre-conditions for evaluation studies in the area of domestic violence perpetrator programmes as it is today, feasible approaches for outcome evaluation are outlined, with recent developments in the field taken as starting points. The framework for organising future evaluation studies of work with perpetrators of domestic violence is presented together with a strategy to promote this framework. International networks of practitioners and researchers play a central role in this strategy through upskilling the area of practical work, preparing the ground for evaluation research and improving cooperation between practitioners and researchers. This paper is based on the results of the European funded project IMPACT (under the Daphne-III-funding programme of the European Commission).     

Accounting for unsafe sex: Interviews with men who have sex with men

Semi‐structured one‐on‐one interviews with 102 gay and bisexual men were conducted to examine the reasoning processes men use to exempt themselves from practicing safe sex. Qualitative analysis of the interviews revealed the following recurring themes: (a) Many men who were in couple relationships avoided condom use for reasons involving intimacy or trust, or because both partners were HIV‐negative; (b) unsafe sex sometimes occurred inadvertently or involuntarily; (c) negative moods and self‐images were associated with unsafe sex; (d) by “intuiting” that their partner was HIV‐negative, participants exempted themselves from the need for safe sex; and (e) when the boundary between safe and unsafe was unclear, participants used a combination of unofficial and official guidelines to determine what is safe.     

Whose job is poverty? the problems of therapeutic intervention with children who are sexually violent

Children who commit sexually violent acts have been identified in increasing numbers since the 1980s. Professionals who practise therapeutic intervention with this group have struggled to find explanations for their client's deviant behaviour. Current explanations for, and discourses on, the occurrence of sexual violence minimize the effect of poverty in the therapeutic arena. The most difficult and worrisome child clients for participants of this research are the poor ones, yet the practice of counselling is unable to address structural disadvantage. This leads to a poverty culture explanation for sexual violence and child abuse which recognizes poverty yet pathologizes the individual. The identification of a new problem—children's sexual violence—the individualized case‐based approach to intervention and current social policy minimize the continuing and persistent problem of poverty. Copyright © 2006 John Wiley & Sons, Ltd.     

Experiencing release: sex environments and escapism for HIV-positive men who have sex with men

There are nonsexual reasons that may motivate people to seek out sexual activity with others. Some men who have sex with men may seek out sex environments to engage in sexual behavior. Among the nonsexual reasons that exist for men who have sex with men is a desire to escape from distressing thoughts and feelings. The amplified sexuality and other unique characteristics of sex environments allow men to have more intense emotional experiences around sex. Using the cognitive escape model as a theoretical foundation, this analysis focuses on the emotional vulnerability that some of the men who visit these venues may be avoiding and how their experiences at these venues might act as releasing mechanisms to alleviate dissonant thoughts and feelings. Implications for public health services and future research are discussed.     

Heterosexually married men who have sex with men: marital separation and psychological adjustment

There have been few investigations of sexual identity and psychological adjustment among behaviorally-bisexual married men. A critical issue is whether such men experience increased psychological adjustment if they exit their primary heterosexual relationship and assume a gay identity. Two hundred and one ever-married men (n = 201) with same-sex sexual interests and behaviors were administered the Brady and Busse (1994) gay identity development questionnaire (GIQ) and the symptom check list-90 (SCL-90) as part of a larger investigation of sexual identity development. The measurement of homosexual identity formation (HIF) using the original nominal scoring criteria for the GIQ did not adequately detail processes of HIF among respondents, and an alternative scoring system that allowed continuous, rather than stage, measurement of HIF was utilized. Psychological adjustment was found to be significantly correlated with HIF among ever-married gay-identified men. Within bisexual-identified men, no relationships between HIF and psychological adjustment were found. Future studies of HIF should clearly differentiate between gay and bisexual men. The findings suggest significant psychological gains accompany public affirmation of gay identity among self-identified gay men who have been in a previous heterosexual relationship.     

Evaluating strategies to avoid AIDS: Number of partners vs. use of condoms

A probability model based on the best estimates we have today for prevalence and infectivity of Human Immunodeficiency Virus (HIV) has been developed. The model is used to compare the two most widely publicized risk reduction strategies: (1) Reducing the number of partners and (2) Using condoms. The results indicate that under almost all conditions of prevalence and infectivity, consistent and careful condom use is a far more effective method of reducing the risk of HIV infection. The analysis is applied to both high and low prevalence groups. In order to test more rigorously the conclusions, infectivity rates ten times higher than now estimated are examined, and infectivity is estimated on a per partner, as well as a per sexual act basis. Epidemic growth of prevalence is estimated to further check our findings. None of these conditions alters our basic conclusion. It is suggested that there is reluctance to publicize such findings about AIDS because they may be used to support having multiple sexual partners. Nevertheless, it is assumed to be more important to protect ourselves from infection than to sustain norms opposed to multiple sexual partners. Thus, our results may prove extremely useful to those who give advice to people concerning risk reduction strategies.     

Righting anachronistic exclusions: The ethics of blood donation by men who have sex with men

ABSTRACT

Recently, the FDA announced that it would soon lift the long-standing lifetime ban on blood donation by men who have sex with men (MSM). Reexamining blood donation by MSM, it is clear that there are several ethical goods that must be balanced. Through balancing the primary duty to safety with the imperatives to craft a policy that is formally equal, upholds the public's trust, and is nondiscriminatory, an ethical blood donation deferral guideline may be advanced, both for MSM and the population at large.     

Teen mothers who are daughters of teen mothers: Psychological intergenerational dimensions of early motherhood

IntroductionResearchers have shown that being a daughter of a teenage mother is a risk factor regarding the possibility of having early, unprotected sexual intercourse and of falling pregnant. The experiences of young mothers in such situations and the aspects of intergenerational transmission in the mother–daughter relationship have not been well investigated.ObjectivesThis study analyses the experience of motherhood in young mothers (18–20 years at the time of the interview/15–16 at the time of their pregnancy) who are daughters of teen mothers themselves from the psychodynamic perspective of intergenerational transmission.MethodsSix young mothers from Southern Italy were selected and interviewed. A semi-structured interview was used to explore the early experience of pregnancy and motherhood and their relationship with their own mothers. The interviews were analysed through Interpretative Phenomenological Analysis (IPA).ResultsFive superordinate themes emerged: I didn't want, I didn't see and I didn't feel; Adolescence? I suddenly became a mother; History repeats itself again and again; Confused Spaces and How difficult is coming into the world?ConclusionAdolescent mothers, who themselves are daughters of teen mothers, seem to have difficulty in representing the meanings associated with their experience of pregnancy and motherhood. A lack of narrative transmission of the experience of pregnancy from mothers to daughters emerged. The implications for research and social policies will be discussed.     

Social work with violent men: a child protection file study in an English local authority

This paper reports on a study of 40 child protection case files that were open in an English local authority in 2007. The study aimed to explore continuities and change in the engagement of men in the child protection system in England. The files recorded that 63 men were involved in the lives of the 71 children who were the focus of the child protection concerns. Quantitative and qualitative data were collected from the minutes of the initial child protection meeting, strategy meetings, professional reports and the first review meeting. The study found high levels of violence in the cases and domestic violence was the most common reason for convening an initial child protection meeting. In common with earlier studies, men were found to be much less engaged in the child protection process than women, domestic violence was underplayed and little attention was paid to men's practical caring skills. Possibly as a result of changes to definitions of child abuse in recent years, this study also found that domestic violence may be used as a lever to initiate child protection processes where there are other concerns and that much more attention was paid to the likely emotional and physical impact of violence on children than on women. It was also found that violent men in this small sample were more likely to be engaged by professionals than men about whom there was no record of violence. Copyright © 2010 John Wiley & Sons, Ltd.     

Responding to the needs of youth who are homeless: Calling for politicized trauma-informed intervention

Trauma in the lives of youth who are homeless is a pervasive reality. In this article, a politicized understanding of trauma is taken up to explore the complex psychological, relational, and social/political challenges experienced by many young persons facing homelessness. Their needs are contrasted with the dominant framework for assessing and addressing homelessness among youth, which fails to adequately account for the effects of trauma in their lives. The authors argue for therapeutic approaches to address the negative effects of trauma; development of community services that adequately respond to the consequences of traumatic life experiences; and socially responsible policies that ensure provision of adequate services and also aim to address root causes of youth homelessness. While current conceptualizations of trauma-informed services go some distance toward achieving these goals, the authors argue that it is only by taking up a more radical understanding of trauma that interventions will be employed to better achieve these targets. Toward this end, the authors introduce a framework that integrates the SPECs model (Evans & Prilleltensky, 2007; Prilleltensky, 2005) with trauma-informed service provision, thereby infusing a social and political analysis to guide more effective trauma-informed solution building in response to the issue of youth homelessness.     

Who are in charge,who do i work with,and who are my friends: A latent space approach to understanding elite coappearances in China

How ruling elite arrange and maintain their power-sharing is key to our understanding of authoritarian politics. We analyze the dynamics of elite power-sharing in authoritarian regimes using a network framework that embeds actors onto a low-dimensional space. We also introduce a novel dataset tracking appearances of elite Chinese Community Party (CCP) members at political events. Our framework and data allow us to disentangle three key aspects of CCP elite power-sharing: (1) who are in charge, (2) who do I work with, and (3) who are my friends. Using a latent factor network analysis of approximately 10,000 appearance records of over 200 top CCP elites from 2013 to 2017, we empirically assess these three questions by computing elites’ total appearances, dyadic coappearances, and their distance in a latent social space. We test how well these three indicators fare at predicting elites’ appointments to the leading small groups (LSGs) of the CCP Central Committee and the Central Government, and from that analysis are able to highlight the need to account for the indirect ties elites share.     

HPV vaccine acceptance among a sample of Southern men who have sex with men: A comparison of younger and older men

Objectives: Do short, online educational messages about the human papillomavirus (HPV) influence younger and older men who have sex with men (MSM) differently? Second, what are the HPV knowledge levels and risk perceptions of Southern MSM living outside of major metropolitan areas? Methods: This study draws on participants who completed an anonymous online survey asking about their knowledge, risk assessment, and vaccine acceptance regarding HPV. Results: Knowledge about HPV was low among the MSM in this study. After reading a one-page information intervention, vaccine acceptability increased by a statistically significant amount among both a Younger and Older cohort but risk perception only increased among the younger respondents. Single men regardless of age cohort reported sharper increases in perceived risk after the intervention, but relationship status did not produce significant differences in vaccine acceptability. Conclusion: Online, brief interventions may be effective means of increasing motivation to vaccinate among Southern MSM.     

The Body Comes to Family Therapy: Utilising Research to Formulate Treatment Interventions with Somatising Children and their Families

Children and adolescents with functional somatic symptoms are challenging to understand and to treat. The challenges begin at the very outset of the intervention – with the neurological and psychiatric assessments. Patients presenting with functional somatic symptoms, as well as their families, frequently deny any emotional or family problem, and parents are often genuinely baffled as to why a child has suddenly become so ill and why no medical explanation is forthcoming. Families can be unwilling to engage in family assessment and therapy, and therapists may find that standard approaches to family therapy simply can end up alienating these families – the door to therapy is slammed shut. This article is the story of my struggle to understand somatising children and their families and to find a common language to enable us to co‐construct formulations, to agree to a treatment plan, and to work together towards a pathway to health. It is also about the role of research and how knowledge from different system levels – and most specifically about the body – may need to be integrated into the therapy to help bring about change.     

Giving HOPE and minimising trauma: An intervention to support women who are separated from their babies at birth due to safeguarding concerns

Whatever the circumstances, the separation of infants from their mothers at birth is a traumatic experience for all concerned. The paper reports on a study designed to improve practice in this highly sensitive area. An analysis of data collected through semi-structured interviews with 38 mothers who had experienced removal at birth identified four common themes: isolation and unacknowledged support needs; shame, stigma and the failure of others to acknowledge their maternal identity; acute trauma, immediate downturn and disenfranchised grief following infant removal; and strategies to mitigate their pain and grief. These last themes included the use of artefacts both as transitional objects to help mothers come to terms with the permanent loss of a baby, and as a means of keeping maternal identity alive and connecting with an infant who might eventually return home. In response to these findings, and in collaboration with a group of women with lived experience, HOPE boxes were designed to ameliorate the trauma and psychological burden borne by women in this situation. The contents of the boxes have been chosen to reflect the changing experiences of the women's journeys but also the range of possible potential outcomes. The intervention has considerable potential to minimise the trauma of this painful experience.     

Family Capital: Implications for Interventions with Families

Social capital has been extensively discussed in the literature as building blocks that individuals and communities utilize to leverage system resources. Similarly, some families also create capital, which can enable members of the family, such as children, to successfully negotiate the outside world. Families in poverty confront serious challenges in developing positive family capital, because of lack of resources. For those families that are successful in developing positive family capital, family capital can help to create positive outcomes for family interactions. Thus, family capital can provide information about opportunities, exert influence on agents who make decisions involving the actor, provide social credentials that indicate a connection to a social network, and reinforce the actor's identity and recognition, which maintains access and entitlement to these social resources.     

Outcomes from a homegrown HIV prevention program for extremely high-risk,substance-using men who have sex with men with multiple health disparities

ABSTRACT

From February 2010 through December 2014, 585 substance-using men who have sex with men (MSM) were enrolled into a “homegrown” risk reduction intervention. Participants evidenced significant iterative factor reductions in the odds of substance use including alcohol (AOR = 0.79) and marijuana (AOR = 0.78; both p ≤ 0.05) and marginally significant reductions in the odds of methamphetamine use (AOR = 0.83; p ≤ 0.07). Participants also evidenced significant reductions in sexual risks including the odds of reporting drug/alcohol use before or during sex (AOR = 0.80) and of condomless anal intercourse (AOR = 0.72; all significant at p ≤ 0.05). Results demonstrate that the homegrown intervention was effective at reducing HIV risk behaviors among high-risk MSM.     

In sickness and in health: A qualitative study of elderly men who care for wives with dementia

It is estimated that approximately 1,000,000 elderly men care for spouses with Alzheimer's disease or other forms of cognitive impairment, yet we have only a limited understanding of their work, and central questions arise. What do men caregivers do, and what meanings do they ascribe to their work? What are their distinctive strengths and vulnerabilities, and what can we learn about men and caregiving from their stories? This qualitative study was based on in-depth, open-ended interviews with 14 elderly men who are primary caregivers to wives with dementia. All interviews were taped, transcribed, and manually coded. The resulting information then underwent analysis from which three major themes emerged: feelings of isolation and invisibility of their care work, a style of caregiving that jointly utilizes management and nurturing, and feelings of commitment, responsibility, and devotion.     

Group interventions for men who batter: a summary of program descriptions and research

This article provides a summary of the latest research on men's group interventions for men who batter their intimate partners. The major components of current programs are described, along with studies on treatment effectiveness. Evidence for the effectiveness of treatment combined with a coordinated community response is also presented. Several related topics are covered, in particular methods for enhancing treatment motivation and culturally competent practice.