Accepting and Negotiating Service Users' Choices in Mental Health Transition Meetings

Across Western welfare regimes, policies emphasize that service users should have more choices regarding their services. This article examines how service choices are presented, responded to and decided in interactions between service users and professionals in mental health transition meetings. Choice is often associated with consumerist user involvement ideas, but in mental health choice also relates to the democratic user involvement approach and to shared decision making between professionals and service users. The results of the study show that professionals construct service users as consumers by offering service options in choice making sequences, expecting users to make appropriate choices. Service users mostly act like consumers by responding to these choice options. However, the study also demonstrates that the professionals do not always accept the user's first choice but respond to them as non‐preferred. Sometimes, they also suggest choices on behalf of the users. In these ‘non‐accepting’ sequences, choices are negotiated in interaction between the parties, rather than users acting as autonomous choice makers. The sequences are based on two kinds of professional reasoning: first, the professional‐led needs assessment and, second, the structure of the service package that the user is being offered. This negotiation has elements of shared decision making and the ‘logic of care’. But it also has elements of paternalist control which challenge both consumerist and democratic service user involvement and suggests consideration of more collectively oriented service user actions.     

Substance use and other factors associated with child welfare case duration: Looking beyond out of home care

Little is known about factors associated with child welfare case duration. Understanding factors associated with case duration may help stakeholders make more informed decisions about funding and service allocation and improve compliance with federal law. This study had two research questions: (1) What factors are associated with child welfare case duration? And (2) Do factors differ depending on whether children were placed exclusively with parents or with others (e.g. relatives and foster care) during the case? The study sample consisted of families (N = 874) with co-occurring child maltreatment and substance use in one midwestern state in the United States between 2007 and 2016. Linear regression models were used to identify correlates of case duration while controlling for child placement status. Overall, having a child under 1 year of age, benzodiazepine use, methamphetamine use and injection drug use were all associated with longer case duration, whereas marijuana use with no other substance use was associated with shorter case duration. Additionally, factors associated with case duration differed based on child placement status during the case. These findings suggest important heterogeneity in families involved with child welfare services and may allow for proactive mitigation of cases at greater risk.     

Notes on School-Based Crime Fighting: International Lessons in Moral Education

Few communities are immune to organized crime and corruption. What has not been fully explored is how education in lawfulness can be introduced into the curriculum of primary and secondary schools to confront the influences of criminal life styles that continue to be romanticized byfactions within a community. This paper reports on such efforts in Sicily, Hong Kong, Russia, and Mexico. Each community is vigorously seeking to repel negative influences from traditional strongholds of organized crime, which continue to exert powerful and pernicious effects on those societies.

Challenging organized crime requires more than governmental regulatory responses. Civic, business, labor, religious, social, and educational organizations all have a role in mitigating the scourge of lawlessness. A central question is to consider the ways in which a civil society can foster a culture of lawfulness. Promoting a set of beliefs and mobilizing the legal norms and institutions for changing, administering, and enforcing laws will enhance and protect “quality of life” is a task that some primary and secondary schools have begun to explore. One approach involves moral education, explicitly and directly teaching children and young people about the rewards and obligations in making moral and ethical decisions. This paper examines this effort in four, distinct cultural settings.     

Black women talk about stereotypical transference enactments in cross-cultural supervision

ABSTRACT

Little is known about cross-cultural supervision dynamics between Black, female supervisors who provide clinical supervision of White supervisees. This study examined transference enactments which occurred between Black, female clinical supervisors (N = 57) and White supervisees. The results show that White supervisees’ racist and sexist behaviors towards the Black, female supervisors demonstrated remnants of stereotypical images historically attributed to Black women (i.e., Mammy, Jezebel, and/or Sapphire). Moreover, the findings highlight the need to initiate multicultural awareness, knowledge, and skills to enhance clinical skills. The paper concludes with recommendations for cross-cultural supervisory dyads and implications for future research.     

Differential Gaze Behavior towards Sexually Preferred and Non-Preferred Human Figures

The gaze pattern associated with image exploration is a sensitive index of our attention, motivation, and preference. To examine whether an individual's gaze behavior can reflect his or her sexual interest, this study compared gaze patterns of young heterosexual men and women (M = 19.94 years, SD = 1.05) while they viewed photographs of plain-clothed male and female figures aged from birth to 60 years old. The analysis revealed a clear gender difference in viewing sexually preferred figure images. Men displayed a distinctive gaze pattern only when viewing 20-year-old female images, with more fixations and longer viewing times dedicated to the upper body and waist–hip regions. Women also directed more attention at the upper body on female images in comparison to male images, but this difference was not age-specific. Analysis of local image salience revealed that observers' eye-scanning strategies could not be accounted for by low-level processes, such as analyzing local image contrast and structure, but were associated with attractiveness judgments. The results suggest that the difference in cognitive processing of sexually preferred and non-preferred figures can be manifested in gaze patterns associated with figure viewing. Thus, eye-tracking holds promise as a potential sensitive measure for sexual preference, particularly in men.     

Violence among child molesters

Although sexual offenses against children have often been characterized as nonviolent, recent information has indicated that a subgroup of very violent offenders exists. The present study examined details of both familial and nonfamilial sexual offenses against children in order to investigate the type of offense committed, as well as the frequency of violence and aggression. Two trained raters were used to code clinical information which examined offenders’ backgrounds as well as details of crimes. Subjects consisted of all in‐patients referred to the Clarke Institute of Psychiatry over a five‐year period who were charged with a sexual offense against a child (29 incest offenders and 37 nonfamilial offenders). The two groups were similar in demographic characteristics, with the exception of the incest group being older and more frequently married. Details of the index offenses revealed that both groups of offenders had penetrated victims in over half the cases, had used physical force (such as beating) in 89% of cases and had used verbal threats in 26% of cases. Victims included a 3‐month‐old infant and seven children between the ages of 3 and 5. Higher levels of physical aggression and verbal intimidation were found among incest offenders. These findings are particularly alarming given that clinical files are often lacking in details of criminal charges and may underestimate the degree of violence in these offenses. The implications of these findings are discussed in terms of generalizability and the myths and stereotypes that surround both the perpetrators and the child victims of sexual assault.