Why They Don't Come Back: A Clinical Perspective on the No-Show Client

Clinical writers love to publish their success stories. Treatment failures get shuffled to the bottom drawer. Perhaps this is why there is so little in the clinical literature about a problem so frequently encountered by the clinical social worker: the patient or client who never shows up or doesn't return. Why don't they keep their appointments? What are the most common dynamics? How much of the problem rests with the client and how much with the clinician or agency? What should be done when your client “no-shows”? When should you do it? This paper will explore these questions in an attempt to deepen the practitioner's understanding and management of this common clinical challenge.     

What should I do?--a study about conflicting and ambiguous warning messages

Warnings are intended to reduce accidents caused by hazards. Behavioral compliance is the most important measure of warning effectiveness. However, in result of diverse circumstances (e.g., distraction, misuse, negligence), conflicting or ambiguous safety messages can be perceived. Since these are recurrent and can result in wrong behaviors encompassing severe consequences, such cases should be studied for safety purposes. We report findings on the participants' compliant behavior when performing a work-related task, while immersed in a virtual environment, and investigate the effect of conflicting messages on compliance with warnings. Two warnings (one regular and one with an appended out-of-order sign) and two types of signs (static and dynamic) were considered. The warning with the out-of-order sign configures the case of potentially conflicting messages. The gender effect was also investigated. The participants' behavior was assessed regarding to pushing a button as directed by the warnings. In the "out-of-order" warning, compliance was higher in the dynamic situation (53.3%) than in the static one (3.3%). Comparing with the non-conflicting warning, compliance was higher for both situations (static: 76.7%; dynamic: 100%). Women complied more than men. Although these results have limitations in their generalization, they are nonetheless relevant and deserve to be studied further.     

Nursing home ownership: an historical analysis

The need to care for dependent elderly in the United States has been a constant since colonial times. Today, as in the earliest days, most care is provided at home by family members. Personal and health services outside the home are sometimes provided by nursing homes. The nursing home industry is large, dominated by private, for-profit ownership, and receives much of its income from public funds. Why are nursing homes publicly funded? Why are nursing homes privately rather than publicly owned? Why is ownership for-profit or proprietary rather than not-for-profit or voluntary? The answers to these questions are found in the history of social policies in the United States.     

Expanding Statistical Frontiers in Sexual Science: Taxometric,Invariance, and Equivalence Testing

Sexual scientists must choose from among myriad methodological and analytical approaches when investigating their research questions. How can scholars learn whether sexualities are discrete or continuous? How is sexuality constructed? And to what extent are sexuality-related groups similar to or different from one another? Though commonplace, quantitative attempts at addressing these research questions require users to possess an increasingly deep repertoire of statistical knowledge and programming skills. Recently developed open-source software offers powerful yet accessible capacity to researchers wishing to perform strong quantitative tests. Taking advantage of these new statistical opportunities will require sexual scientists to become familiar with new analyses, including taxometric analysis, tests of measurement variability and differential item functioning, and equivalence testing. In the current article, I discuss each of these analyses, providing conceptual and historical overviews. I also address common misunderstandings for each analysis that may discourage researchers from implementing them. Finally, I describe current best practices when using each analysis, providing reproducible coding examples and interpretations along the way, in an attempt to reduce barriers to the uptake of these analyses. By aspiring to explore these new statistical frontiers in sexual science, sexuality researchers will be better positioned to test their substantive theories of interest.     

Sociology of Debt: States,Credit Markets,and Indebted Citizens

Within the context of the recent financial crisis, the causes and implications of mounting levels of household indebtedness have begun to be examined from a variety of angles: Why have nations differed so drastically, historically speaking, in terms of the level of debt that their citizens carry? Why have patterns converged over the past few decades, with levels of indebtedness increasing across the board? This paper considers these questions from a sociological perspective. I first consider the role of political, institutional, economic, and cultural factors, as well as individual characteristics, in shaping the demand for and supply of credit and the degree and nature of household indebtedness in and across nations. I then attempt to explain the cross‐national convergence towards rising indebtedness over the past few decades by situating the transformation of these various demand and supply side factors under the neoliberal regime.     

Challenges,pride, and connection: A qualitative exploration of advice transgender youth have for other transgender youth

Abstract

Transgender youth experience a variety of risk and resilience factors that impact their wellbeing. However, the research on these factors rarely includes the personal perspectives or authority of transgender youth. To address this gap, we collaborated with a transgender youth advisory board to conduct qualitative interviews with 19 transgender youth (15–22?years-old). Participants lived in two Midwestern states to provide the perspective of transgender youth often missed by research. Data were analyzed using thematic analysis and resulted in three categories of advice: challenges are real, have pride, and you are not alone. Participants acknowledged that challenges are a salient aspect of growing up as a person who is transgender but provided advice for their peers to persevere, feel proud of their identities, and support development and wellbeing through connections to others. Findings provide important implications for practitioners working with transgender youth and researchers aiming to promote resilience and reduce risk. Additionally, providing opportunities for transgender youth to participate in research as the experts and share their perspectives may also help promote resilience.     

Are elderly drivers a road hazard?: Problem definition and political impact

Elderly drivers are increasing in number and some statistics show they are more likely to be involved in fatal accidents than all other age groups but those under 25. States have attempted to address the problem in various ways, but very few have required mandatory retesting at license renewal for those beyond a particular age. Why have so few states chosen to act? The key is how the issue is framed for the public and decision makers. Several phases of problem definition are explored to explain the political dynamics of the older driver issue: incidence, causality, severity, crisis labeling, problem population characteristics, and linkage of values to the issue and solutions. Based upon this analysis, it is not surprising that elder interest groups have been successful in containing policy initiatives designed to restrict elderly driving.     

Domestic violence research: Theoretical and practice implications for social work

Identified in the late eighties as the number one public health risk to adult women by the Surgeon General of the United States, domestic violence remains the leading cause of injuries to women, ages 15 to 44, more common than muggings, auto accidents and cancer deaths combined (U.S. Senate Judiciary Committee, 1992). Academics and practitioners have assessed the problem and its potential solutions using both quantitative and qualitative research methods. Yet, how far have we come and how much do we really know? This paper will attempt to answer these questions by critiquing the “current state of affairs” of domestic violence research. Common theories of causation and their applications to social work theory and practice will be delineated and an ecologically based intervention for domestic violence will be proposed.     

When T cells get old

Why is vaccination against infectious diseases less effective in older patients than in younger ones? Why do the elderly suffer from more frequent and severe infectious episodes than the young? The answer to both these questions is immunosenescence--the poorly defined changes that occur in the immune system as a result of the disrupted performance of multiple components of immunity. Presentations from a recent workshop, which are summarized here, examined these questions and provided some insights from the perspective of improving vaccination strategies among the elderly.     

Qualitative computing--a methods revolution?

Qualitative computing is often described by enthusiasts as revolutionary, but in stark contrast, its methodological innovations are rarely discussed. Why is the debate missing? The paper charts some of the major developments in support for coding and theory-building, exploring the many reasons why these are either taken for granted or unrecognized and often unused. Whilst these tools had the potential to change methods, their adoption and their impact have been uneven, and they have been subjected to remarkably little sharp and critical debate. The paper concludes by asking what is required if researchers are to benefit from and drive this technological change.     

A tool for selecting residential child care workers: an initial report

What strengths and talents make an outstanding child care worker? How can these qualities be measured? How can one predict whether an individual will succeed as a child care worker? The authors attempt to answer these questions by focusing on the "life themes" of highly rated child care workers and using a technique to measure these themes.     

The changing practice of urban planning

The purpose of this paper is to explore the changing nature of urban planning practice in the Third World. I shall seek to answer four main questions. First, what changes have there been in recent years? Second, why have these changes occurred? Third, are these changes, on balance, for good or ill? And fourth, what will or should happen next? Clearly these are ambitious questions to ask under any circumstances. And within the scope of a short paper such as this it may be regarded as reckless even to make the attempt. But I hope that the paper may at least clarify some of the questions, even if it fails to provide all the answers.     

“Should I Trust the Bank or the Social Movement?” Motivated Reasoning and Debtors' Work to Accept Misinformation

How can people believe corporate and state misinformation even if a social movement organization in their community has been countering this misinformation for years? Why do people knowingly accept misinformation without even being upset about it? I address these questions by analyzing ethnographic data and interviews with 84 Chilean low‐income housing debtors, whom, like many Chileans, are victims of financial misinformation. While the state and banks had significant agency in inducing the unproblematic acceptance of misinformation, debtors also played an active role in the processes. First, debtors had to decide whom to trust, which was not only a cognitive problem about evidence but also a behavioral and practical problem involving risks. Second, debtors engaged in “motivated reasoning”—affect‐driven biased information processing—to dismiss the possibility of being misinformed, to downplay the significance of misinformation, and to direct blame away from misinforming institutions. The latter two practices reduced debtors' anger about being misinformed. The findings have implications for studies of social movement framing and counterinformation, for the cognitive psychology of misinformation, and for the sociology and social psychology of acquiescence.     

To risk or not to risk? Uses and limitations of Mary Douglas on risk acceptability for understanding health and safety at work and road accidents*

The recent Greening of politics in the West has encouraged rapid development of research into both environmental hazards and risk perceptions among the public. There are also longstanding traditions of research into behaviour under risk in such disparate fields as superpower relations (Allison 1971), inter-country commercial transactions, the economics of uncertainty, and the study of natural disasters (Torry 1979). Relatively few sociologists or social anthropologists have contributed. A major exception is Mary Douglas (1982,1985,1987). This paper is an attempt to make use of her work and to tests its limits, in answering two empirical questions: How do managers and workers address workplace hazards? And, how do motorcyclists and drivers behave on the roads?     

Winnicott and clinical social work: A facilitating partnership

This article examines the applicability of D. W. Winnicott's theoretical concepts to clinical social work practice with clients whose psychosocial well-being has been compromised by environmental deprivation and related developmental vulnerabilities. This examination is organized around three questions: (1) Why is Winnicott relevant for social work? (2) Which of his concepts are most useful for social workers? (3) How can these concepts be put into practice with social work problems and populations? The translation of theory to practice is illustrated with case material.     

Whistleblowing processes in Swedish public organisations—complaints and consequences

Research on whistleblowing in Sweden is scarce. In this explorative study 21 cases of whistleblowing from human service organisations in Sweden were examined. Extensive material from thematic interviews with 28 whistleblowers, 30 key persons and documents from supervisory authorities such as the National Board of Health and Welfare have been analysed.

Some findings were that the organisation problems motivating whistleblowing were usually cutbacks in vital services for users, unethical working methods or abuse of clients. Internal whistleblowing was usually met with silence from supervisors and directors. The whistleblowers then went on with external whistleblowing by reporting the bad conditions to the higher supervisory authorities who started thorough investigations. Their actions caused a lot of negative reactions in the organisation, but they were also supported by media and ordinary citizens.

The retaliation processes against the whistleblowers were described. Half of the interview group has left their positions, either on sick leave or by changing jobs. The findings show a stigmatisation process with severe consequences for the individuals. But the cited organisations usually had to change their illegal or immoral practices and benefited in the long run from the whistleblowing events.     

White Professors Taking Responsibility for Teaching White Students about Race,Racism, and Privilege

How does a white professor teach a course composed of predominantly white human-services students about race, racism, and privilege? What are some of the pitfalls? What works? What is challenging? Why should such a course be part of the undergraduate human services curriculum? This article investigates these questions by exploring a course taught by the author, “Exploring Race and Challenging Racism in the United States.” A variety of pedagogical tools and approaches are discussed.     

Becoming Resilient: Overturning Common Sense — Part 1

How might we engage with the concept resilience in a world obsessed with the measurement and cataloguing of deficits and virtues alike; with predicting outcomes, producing certainty and the reification of stable identity? This article is based on a plenary address presented to the Australian Family Therapy Conference in 2009 and takes Deleuze's paraphrase of the 17th century philosopher, Spinoza as a point of departure from common sense views of identity. Can resilience be possessed by some as a personal quality enhancing their coping skills or might resilience be a vital aspect of living which passes through us? Perhaps resilience bounces back towards us and enables the unsettling of dogmatic beliefs and a stable sense of identity Enquiry might then shift from the moral; What kind of person am I? How should I live? towards an ethical position of wonder; What else might there be? What might I be capable of?This article invites an ethical exploration of desire, its capture and of resistance and explores the politics of identity; illustrated with men's journeys of struggle with violence, sexuality and belonging and the discovery of ethics and generous forms of love in the face of adversity.