Resolutions

Abstract

A means of monitoring therapists' conformity with policy in a mental health clinic is the examination of annual utilization data. Specifically, graphs which display the frequency of different lengths of patient contracts reveal much about the working realities of how a clinic actually functions. Data from the mental health clinic at the University of Rochester's Student Health Service illustrate changes in staffing and ideology over a seven year period. The graph of current utilization reveals three relatively distinct cohorts of patients. Each cohort can be explicated with regard to clinical needs of patients, staff educational needs, or the clinic's embrace of time-limited therapy as a valued treatment modality. Periodic examination of such graphs can reveal whether actual practices correspond to stated ideology and policy.     

A Comprehensive Approach to the Treatment of Gender Dysphoria

After a brief historical review of the clinical management of gender dysphoria, the authors argue for a comprehensive treatment model that recognizes a wide spectrum of gender identity disorders. This treatment model explores the meaning of a gender dysphoric individual's desire for sex reassignment in the context of the individual's biography and psychosociosexual adjustment. Unlike previous treatment approaches, this model makes no attempt to identify the 'true' transsexual. The model's treatment tasks are: assessment, management of comorbid psychiatric disorders, facilitation of identity formation, sexual identity management, and aftercare. The implications of this treatment model for classification and ethical standards of care are discussed.     

The Prevalence of Dental Anxiety in Patients of a University Dental Clinic

Dental anxiety remains a pervasive barrier to dental treatment for many individuals, including college-age patients. In this article, the author reviews dental anxiety and examines the usefulness of assessment instruments for identifying dental anxiety. Using 2 unique assessment instruments, he examines the prevalence of dental anxiety in his university dental clinic's patient population. The 2 assessment instruments were determined to be equally effective in identifying anxious dental patients. Both instruments revealed that the average patient surveyed had low-to-mild dental anxiety. The results of this survey concur with those of previous studies of college-populations.     

Another Way of Talking About Substance Abuse: Substance Abuse Screening and Brief Intervention in a Mental Health Clinic

This article provides experiential evidence on the transportability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) screening tool and brief intervention in a mental health clinic. There is very little published information on implementing screening and brief intervention (SBI) in a mental health setting. Moreover, few SBI projects have reported on clinicians' experiences using the ASSIST. The article documents a successful attempt at implementing the ASSIST and discusses the benefits and challenges of doing SBI in a mental health setting.     

Brief Family Therapies

A modified version of Guerin's (1976) classification was used to categorise the principal models of brief family therapy according to theoretical and technical dimensions. While all models stemmed from common origins, either psychodynamic or systems theory, they differed in three particular areas: the premises regarding the origin of symptoms, the aims of therapy, and the major strategies employed. Nevertheless, all models were in agreement on several aspects, including the principles underlying brief family therapy techniques, the focus on the family's current level of functioning, the importance of clearly defining the problem (but not necessarily in terms of traditional psychiatric diagnoses), and other family variables. A survey of the literature indicated that there was a paucity of scientifically acceptable investigations of brief family therapy, and thus, a lack of valid evidence that any model provided an effective approach to therapy.     

The Marijuana Check-Up: A Brief Intervention Tailored for Individuals in the Contemplation Stage

ABSTRACT

A brief intervention tailored for marijuana users in the contemplation stage of change is presented. This “no pressure to change” approach employs principles of motivational enhancement. Empirical support for brief interventions is reviewed. Rollnick and Miller's motivational interviewing principles are outlined, with particular emphasis on stage-specific tasks faced by individuals at early stages of readiness for change based on Prochaska and DiClemente' s Transtheoretical Model of Change. The history and utility of the “check-up” as a viable intervention for individuals in earlier stages of change is also described. The Marijuana Check-Up makes use of a personalized diagrammatic feedback report on the individual's personal use, providing a focus for the one session interview. Clinical challenges and therapeutic response are illustrated with typical case vignettes germane to the Marijuana Check-Up.     

A Brief Reply to Dutton

ABSTRACT

This article is a brief reply to Dutton's rebuttal (Dutton, this issue) to the author's critique of Dutton's analysis of the role of gender in intimate partner violence.     

‘Let's Talk About Children’: Investigating the Use of a Family‐focused Intervention in the Gambling Support Services Sector

The family‐focused mental health intervention, ‘Let's Talk About Children,’ has positively influenced the lives of families affected by parental mental illness. This paper outlines the use of this brief, strengths‐based intervention for parents with gambling and other co‐occurring issues from the gamblers’ support services sector. Over a six‐month period, a training manual and accompanying resources were adapted for the gamblers’ support services sector and a targeted training session developed. Nine problem gambling counsellors from three Victorian gambling support services trialled the Let's Talk About Children intervention over a four‐month period. Qualitative data were gathered through focus groups, interviews, and practice enquiry groups to determine the impact of the Let's Talk About Children model for gambling support services. The results are presented as ‘practice wisdoms and recommendations’ reporting on the impact of the trial and to provide some guidance to support others in the implementation of a specific family‐focused intervention. This paper reports on the first exploratory trial of Let's Talk About Children for the gambler's support services sector in Australia.     

Social work intervention with bereaved children

Abstract

Bereavement in childhood can seriously affect a child's development. There is a tendency to diminish the child's experience of loss because bereaved parents are often less sensitive to their children and because children express their grief in a more discreet manner than is typical of adult grief. This tendency leads to the child's needs being underestimated and under-reported. A model of social work intervention which advocates short-term involvement has been shown to have a significant effect upon the well-being of the child and his family. The paper begins with a brief review of the literature on mourning, which highlights various perspectives on the role and nature of the process. A model of mourning which embraces the differences between adult and child mourning will be proposed which is informed by the principles of attachment theory and defined as a continuing process of adjustment rather than a resolvable experience of loss. This model of mourning has implications for social work intervention and is the foundation of the practice model. The practice model involves six bereavement counselling sessions with the parent, six play sessions with the child and formal and informal involvement with the child's teacher. It has four aims: (I) to enhance sensitivity in the parent to the child's experience of loss and mode of mourning, (2) to develop an improved pattern of communication within the child-parent relationship, (3) to develop resources for the child in his personal environment and (4) to enhance the child's resourcefulness within his mourning thus enabling him to feel more competent in the longer term. The model is founded upon an awareness of the need for short-term intervention within the context of a long-term issue and seeks to address both perspectives simultaneously. Some of children's commoner responses to bereavement will be outlined within the context of the play sessions and methods for resolving the problems associated with them will be discussed. Finally the nature of reasonable outcomes for the work will be considered.     

The Social Studies Teacher and the Course in Occupations

Introducing students to the segregated history of America's public beaches and pools can provide teachers with a novel approach to the study of racism in U.S. history. While most students are aware of segregation in housing, schools, and theaters, many are surprised to learn about the segregated history of America's public waters. This article provides a brief history of America's segregated public beaches and pools using Florida as a case study, offers pedagogic strategies, and presents resources that are helpful for teaching about this important period in U.S. history.     

Exploring Women's Retirement: Continuity,Context and Career Transition

This paper reports on an exploratory study examining women's views about and experiences of retirement. It has long been recognized that women's careers often follow a different path than men's due to the differential impact of family and domestic responsibilities and their relative underrepresentation at higher levels of organizations. However, many studies of retirement have implicitly assumed a conventional male career as the norm, where retirement is seen as marking a neat ending to continuous employment. This paper aims to present a richer understanding of women's retirement, utilizing contextual national data and qualitative analysis. The paper begins with a brief summary of literature looking at women's career development. We then explore the concept of retirement and consider current literature with regard to women's retirement. Following a brief discussion of our research approach, we provide some national context using quantitative data. We then discuss the qualitative findings, examining the areas of continuity and change that women experienced in retirement and exploring the factors that they felt enabled and constrained them.     

Reading and Writing,Talking and Listening Introducing Studies in Gender and Sexuality

This essay offers a brief history of how the stereotype “the female homosexual” was created through three installments of psychoanalytic theorizing, starting with Freud's (1920) case study. A second, brief history presents the various strands of critical theorizing that have identified “the female homosexual” as a stereotype. The essay then makes a contribution to current discussion of female homosexuality by suggesting an instinct theory that features ego instincts and sexual instincts interacting (as Freud' theory did before 1920). Reference is made to Takeo Doi's concept of amae (expectation of affection) and to amae as an ego instinct. This theory then is the framework for a clinical v ignette focused on a female homosexual's ego-instinctual needs.     

Examination by triangulation: A model for practice teaching

Problems in measuring students' practice abilities are briefly described. A model of examining the competence of students on placements is described. A brief example of how the model might work in practice is offered.     

Laughter in the Clinic: Humor as Social Organization

While humor has been studied empirically in a wide variety of organizational settings, other than Coser's (1959) study of a private psychiatric hospital, its actual usage in medical locales has barely been addressed. This article extends Coser's analysis by examining humor as a central dimension of social organization in a university-based outpatient clinic. Using observational data gathered during a two-year period, we examine interactions between key participants in clinic life: attending physicians and residents; the residents themselves; residents and nurses; residents/attending physicians and patients; and finally, the researchers and clinic personnel. We demonstrate how humor may bond members through laughter about common concerns and problems, while also marking them off from others with differing concerns. As such, it ideally illustrates the micro/macro interplay of face-to-face relations and structural contexts.     

11-M: a lesson on greedy journalism

Through the analysis of Spanish media coverage of the terrorist attack in Madrid 11 March 2004, and specifically of the so-called ‘conspiracy theory’ sustained by certain media for political or commercial reasons with large public success, this article examines the consolidation in Spain of a kind of journalism that tries to model with Lewis Coser's concept of ‘greedy institution’. The political functions of this ‘greedy journalism’ and its relationship with the so-called ‘neo-populist turn’ of present politics in Western democracies are discussed in brief.     

Social security reform: Does partial privatization make sense for China?

By the year 2025, one quarter of the world's population over age 60 will be living in China, a nation in the process of partially privatizing its social security system. This article presents a brief history of social security policy in China, describes the current scheme, presents an analysis of the pros and cons of this scheme, and asks why China is currently on the road to adopting policy changes that are so strongly influenced by the neoliberal social security model being advanced by the World Bank. Social security policy in China is being driven largely by demographic considerations, but it is also being influenced by factors linked to globalization. The plan to partially privatize the nation's social security system will put at risk many vulnerable categories of the population, particularly women, low-wage workers, those in the informal sector, and recent immigrants from rural areas.     

Illusion — Money — Illusion: Viktor Pelevin and the 'Closed Loop' of the Vampire Novel

Abstract

A brief contextual discussion is presented of the Russian history of the vampire genre and its spiritual critique of the human condition in both the nineteenth and twentieth centuries, encompassing texts by Gogol, Turgenev and Bulgakov, as well as the well-known Dozor teratology by Sergei Luk'ianenko). It addresses the question of whether the vampire in this context is principally Romantic transgressor, moral object lesson, political metaphor, or capitalist bloodsucker. The principal focus of the article is Viktor Pelevin's 2008 novel Ampir V (Empire V), set in a new Russian empire of 'benevolent' slavery, in which humans are prey to the vampires who live amongst them. The argument is that Pelevin's novel addresses issues such as political predation, capitalism, and consciousness; the mind-capital link can be analysed within a broadly Jamesonian/Deleuzian model of consciousness under late capitalism. Pelevin uses vampires, hidden creatures of the night, to divine the darkness of self-delusion, asking what one might know and how one might know it, given a world of illusions, shadows, and deception. Although (briefly) acknowledging the forces of faith and of love, he concludes that addiction to illusion is the human condition; thus Pelevin's formulation of human destiny as 'illusion–money–illusion'.     

Clients' Attributions of the Presenting Problem and the Therapeutic Alliance in Couple Therapy: Systemic Versus Intrapersonal Perspectives

The therapeutic alliance is central to couples' therapy success. The current study examined associations between couples' initial agreement and causal attributions of the presenting problem and changes in the therapeutic alliance. To test study hypotheses, 85 couples were recruited from a university training clinic focused on couple and family therapy. Couples completed an intake questionnaire concerning their attribution of the presenting problem, either as systemic or individual, and therapeutic alliance was assessed at the end of sessions 2–8. A dyadic multilevel model revealed that a disagreement in the couple's attributions of the problem (with one viewing it as systemic, the other as individual) was associated with a larger initial discrepancy in the couple's therapeutic alliance, as well as a decline in the discrepancy over time. Findings were discussed in the context of systemic family theory, with implications for improving assessment, treatment, and psychoeducation aimed toward couples in distress.     

Sarah Bernhardt,Live: A Reply to Allen Ellenzweig

This article seeks to retrieve something of the effect of Sarah Bernhardt live. It begins with a brief discussion of Sarah Bernhardt's reputation for breeches roles. From there, and in dialogue with Allen Ellenzweig's conception of Bernhardt's “persistent dualities,” the article moves on to analyze an additional duality: Bernhardt's movement between life and death. Here, I ask what the “Divine Sarah's” willingness to die nightly may tell us about anti-Semitism, social death, and the paradoxical resilience of the live.