Evidence of Potentially Harmful Psychological Treatments for Children and Adolescents

This paper applies the concept of potentially harmful psychotherapies (PHTs; Lilienfeld, Perspectives on Psychological Science 2(1):53–70, 2007) to concerns about potentially harmful treatments for children and adolescents (PHTCs). I propose that such treatments can be identified by methods derived from the Adverse Childhood Experiences (ACE) Study and from the NIS-4 study of abuse and neglect, as well as by their plausibility or congruence with established child development theory and research. Five psychological treatments for children and adolescents that have been reported as harmful are examined, using evidence from published materials, journalists’ reports, legal documents and Internet sites. Details of treatment and outcomes are compared to relevant ACE and NIS-4 criteria and to plausibility, and empirical support for the treatments is examined. The examined treatments use methods that would be considered adverse childhood experiences or abusive or neglectful care events if they occurred outside a therapeutic setting. Most, but not all, lack empirical support of effectiveness and are incongruent with established information about child development. Risks associated with PHTCs can thus be identified through close examination before children are exposed to them and harmed. Prevention or reduction of PHTC use may be possible. Public and professional education about PHTCs are essential parts of child protection in this context and are arguably an ethical obligation of both social workers and psychologists.     

The how and the why: Competences and holistic practice

Social work education and training in the UK was, in the 1990s, restructured on a competence-based model. Drawing on the literature and a survey of students from one Diploma in Social Work programme, this paper offers a critical appraisal of this approach to social work education, placing it in the context of opposing ideological frameworks. It reviews the strengths and limitations of the system and discusses some of the problems and dilemmas arising in training for work involving values conflicts and complex tasks. It argues that there is a need for a new synthesis drawn from the strengths of technical rationalism and holistic reflective practice.     

Deaf and hard of hearing faculty in higher education: enhancing access,equity, policy,and practice

Higher education institutions are often well prepared in terms of accommodation policies and practices for disabled students. Ironically, campuses are often not prepared once disabled academics return as faculty. Most are particularly unfamiliar with the unique access needs of deaf or hard of hearing academics. This can result in career hindrances to employment and tenure, as well as potential losses to campuses in terms of diversity. Background and substantiation on this access issue is provided along with recommendations for policy-making and practices for campuses that are geared to ensuring career success for deaf and hard of hearing faculty.     

A care coordination program for substance-exposed newborns

The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by perinatal substance use. Findings from VIP-RI's final four years show that by 12 months, 86% of substance-exposed newborns had identified permanent placements and 77% were placed with biological parents or relatives.     

The evaluation of the PACA regional public health plan: reconciling the managerial, scientific and democratic finalities

For more than a decade now, evaluation has developed considerably in France, thanks in particular to the Société Fran?aise de l'évaluation, whose charter sets out a number of principles designed to guide the work of evaluators. This article examines how the evaluation process surrounding a regional public health plan (referred to as PRSP)--itself being a new instrument for regional planning in France--accords with one of these principles, which specifies that evaluation must be framed according to "a three-fold logic involving public management, democracy and scientific debate." Our analysis shows that while this evaluation was driven primarily by managerial concerns (i.e., assessing the capacity of the plan to structure health policy in a region), it also provided an Opportunity for restoring dialogue with a range of actors by opening up a space of cooperation and consultation. In addition, in order to ensure the legitimacy of the evaluation's conclusions, the knowledge produced by the evaluators had to rest on an irreproachable methodology. This example illustrates how evaluation, in the French tradition, is a process that strives to reconcile the viewpoints and expectations of managers, scientists and the general public; it is also a process that brings out lines of tension and areas of complementariness between these three logics.     

A Lesbian Story

The photographs that follow were produced as part of a visual art exhibition project, A Lesbian Story during 2006–2008, which investigated the dearth of photographs of lesbians in South Africa. A component of the project was a workshop, the aim being to gather diverse opinions and diverse experiences of what it means to be lesbian in South Africa, and to represent aspects of one’s identity visually using photographs. Zanele Muholi and I worked together in preparing and presenting the workshop in Johannesburg during March/April 2007. Mmapaseka Letsike was one of eight women who participated. The photographs and the captions are hers.     

Mom and Pop Versus the Big Boys: Adult Family Homes as Providers of Medicaid-Funded Residential Care

This paper compares assisted living apartments (ALs), adult residential care facilities (ARCs), and small adult family homes (AFHs) for Medicaid residents in Washington State, with particular emphasis on the settings, staffing, services, and policies of AFHs. We targeted for enrollment all residents entering an AFH, ARC, or AL setting on Medicaid/state funding in a three-county area of Washington State. We obtained information on 199 settings, interviewing administrative and direct care providers. AFHs are smaller than ARCs and ALs and less likely to be part of a chain, with no significant difference in staffing ratios of registered nurses and licensed practical nurses. Sixty-four percent of AFH residents were receiving public funds compared to 32% of AL residents. AFHs report admitting residents with more activities of daily living needs, health conditions, and behavior problems. They are less likely to have autonomy-related policies, and they provide more services and fewer activities. While attention should continue to be paid to staff supports, policy and practice should support the continued role of AFHs, which are of special interest because of their potential to provide more homelike, less costly care but with possible trade-offs compared to larger facilities.     

NEW LABOUR'S TEENAGE PREGNANCY POLICY

This chapter explores the changing governmental approach to the problem of teenage pregnancy in the UK. It argues that there has been a shift from moral traditionalism towards individualized approaches based on promoting responsibility, agency and prudent choice-making. New Labour's approach to teenage pregnancy marks a decisive turning point in governmental regulation, documenting the failure of previous approaches and establishing three distinctive discursive strategies:

1. risk management through knowledge acquisition;

2. constituting active knowing welfare citizens;

3. reconstituting blame.

The paper ends by examining how this approach forms part of New Labour's combined and contradictory project of ‘modernizing the social’ and ‘remoralizing welfare’.     

Comparing Service Use of Early Head Start Families of Children With and Without Disabilities

The current study compared patterns of service utilization reported by Early Head Start (EHS) families of children with and without disabilities by secondary analysis of data from the longitudinal investigation of the effectiveness of EHS. Findings reveal comparable positive trends for both groups of families for receipt of services corresponding to EHS performance standards promoting child and family development, family support, and health care. Service challenges remain in the low use of dental services overall and the higher use of acute health care services for children with disabilities. Future research should examine causes and outcomes of service use.