The development of core competencies for the practice of marriage and family therapy

In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.     

Neurobiological effects of childhood abuse

Child abuse and violence are significant public health problems. Research indicates a strong correlation between early childhood abuse and enduring neurobiological changes in specific regions of the brain. These neurobiological changes are often reflected in psychopathology and lifelong maladaptive behaviors. However, emerging research suggests that these neurobiological changes may be modified through specific evidence-based interventions. Nurses must be able to evaluate the current research and translate the findings into their practice, remembering that prevention is the most effective remedy for abuse and violence.     

Virgin College Students' Reasons for and Reactions to Their Abstinence From Sex: Results From a 23-Year Study at a Midwestern U.S. University

Sexual activity is normative in college. Thus, college students who are virgins are a minority; they are also an understudied group. This study extended a prior investigation (Sprecher &; Regan, 1996 Sprecher, S., &; Regan, P. C. (1996). College virgins: How men and women perceive their sexual status. Journal of Sex Research, 33, 3–15.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) that focused on U.S. college virgins' reported reasons for and reactions to virginity. Data were collected from the same university over an additional 18 years and from more than 700 additional virgin students. We found differences between male and female virgins that showed that men are more reluctant virgins. For example, the only reason for being a virgin that male virgins endorsed to a greater degree than did female virgins was “my partner was not willing.” Men also had more negative affective reactions to being a virgin than did women. We also found some variation in reasons for and reactions to virginity based on sociodemographic variables such as religiosity and ethnicity. A temporal analysis revealed that reasons for being a virgin that referred to a fear (e.g., fear of AIDS and other sexually transmitted infections) became less important over the 23-year period. We discuss our findings in the frameworks of evolutionary and social exchange theories.     

A novel test to compare two treatments based on endpoints involving both nonfatal and fatal events

In a clinical trial comparing two treatment groups, one commonly‐used endpoint is time to death. Another is time until the first nonfatal event (if there is one) or until death (if not). Both endpoints have drawbacks. The wrong choice may adversely affect the value of the study by impairing power if deaths are too few (with the first endpoint) or by lessening the role of mortality if not (with the second endpoint). We propose a compromise that provides a simple test based on the time to death if the patient has died or time since randomization augmented by an increment otherwise. The test applies the ordinary two‐sample Wilcoxon statistic to these values. The formula for the increment (the same for experimental and control patients) must be specified before the trial starts. In the simplest (and perhaps most useful) case, the increment assumes only two values, according to whether or not the (surviving) patient had a nonfatal event. More generally, the increment depends on the time of the first nonfatal event, if any, and the time since randomization. The test has correct Type I error even though it does not handle censoring in a customary way. For conditions where investigators would face no easy (advance) choice between the two older tests, simulation results favor the new test. An example using a renal‐cancer trial is presented. Copyright © 2015 John Wiley & Sons, Ltd.     

Embarking on self-directed support in Scotland: a focused scoping review of the literature

This article presents findings from a focused scoping review of the published literature on self-directed support (SDS), the term adopted by the Scottish Government to refer to its policy to improve social care outcomes and choices for people using publicly funded services and to distinguish it from personalisation, the term more commonly used in England, and from consumer-directed-care and cash for counselling. The review was undertaken to inform an evaluation of the early adopters of SDS, funded by the Scottish Government 2009–2011, and was updated with later literature. It focused on the evidence base available to inform the Test Sites' (pilot local authorities) efforts to reduce bureaucracy or ‘red tape’ for people choosing their own social care and support; the available evidence about leadership and training to support these changes and about the use of specific transitional funding to ease the process of implementation. The findings of the literature review around these three themes are presented and discussed. The article concludes with a discussion of the potential for such focused literature reviews to inform policy-makers, researchers, and social work practitioners across Europe of the options available when seeking to combine rapid yet rigorous approaches to evidence.     

Valuing lives equally: Defensible premise or unwarranted compromise?

This article examines the nature of the restrictions on the underlying social welfare function that would appear to be required in order to justify the application of a “common” Value of Statistical Life (VSL) for any particular hazard within a given society and considers the way in which the magnitude of this common VSL might relate to the values actually employed in practice. The article also considers the question of whether, by contrast, discounts or premia might legitimately be applied to the VSL in order to take account of factors such as age or current exposure to risk and explores the form that such discounts or premia might reasonably take.

Citizenship and Consumerism in Health Care: A Critique of Citizens' Juries

This paper examines the strengths and weaknesses of citizens' juries as a model for public involvement in health care. It does so through observation of two citizens' juries run by the same Health Authority, during the summer of 1996. The framework used to evaluate the juries is that provided by IPPR in their 1997 Report, namely focusing on the themes of information, time, scrutiny, deliberation, independence and authority. Citizens' juries are compared and contrasted with other models for public involvement and linked with the broader debate on citizenship theory and practice.     

Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping

During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive Development^SM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.     

Grandparent Carers,Child Protection Practice,and the Best Interests of Children: A Case Study

Increasingly, grandparents are involved in the care of grandchildren, particularly after child safety concerns. Some grandparents, because of changed circumstances, relationships, or decisions made, can experience reduced or lost contact with grandchildren. A recent qualitative, collaborative study explored how relationships between grandparents and their grandchildren could be optimised after child safety concerns. Many grandparents in that study spoke of the frustration of being overlooked in decision-making about their grandchildren, even when they had been providing primary care for the grandchildren. The purpose of this article is to provide a brief background study context, before presenting a case study of one family's ongoing struggles to maintain the children in the grandparents’ care. The presented case study has relevance for social work education and training and more widely, for all students and practitioners in the child protection field.