A comparison of univariate and multivariate multilevel models for repeated measures of use of antenatal care in Uttar Pradesh

Summary.  We compare two different multilevel modelling approaches to the analysis of repeated measures data to assess the effect of mother level characteristics on women's use of prenatal care services in Uttar Pradesh, India. We apply univariate multilevel models to our data and find that the model assumptions are severely violated and the parameter estimates are not stable, particularly for the mother level random effect. To overcome this we apply a multivariate multilevel model. The correlation structure shows that, once the decision has been made regarding use of antenatal care by the mother for her first observed birth in the data, she does not tend to change this decision for higher order births.     

ANZJFT Symposium: What are the Core Learnings of Family Therapy?

Five experienced Australian and New Zealand family therapists and trainers seek to answer the question: ‘What key concepts and core learnings should be part of any family therapy training course?’ They debate the usefulness of making ‘shopping lists’ of core concepts, the importance of considering trainers' and trainees' contexts in the formation of their values and perspectives, and the distinctive role of Family of Origin work in training, clarifying central themes. Three experienced trainers respond to the issues raised.     

A review of national school-age pregnancy and prevention information clearinghouses

School-age pregnancy is a major social problem that affects youth, families and communities. The complexities of school-age pregnancy demand that social work practitioners have knowledge across diverse fields and keep abreast of changing sociopolitical trends. Information clearning-houses have been developed to assist practitioners in their efforts to keep abreast of a particular field of practice. This paper identifies major national information clearinghouses that provide resources for practitioners who work in the field of school-age pregnancy and prevention.     

Teaching hypothesising skills from a post-Milan perspective

The Milan model relies upon careful hypothesising, a therapeutic stance of neutrality and circular questioning on the part of the therapist in order to release new information into the family system. Current thinking incorporates a postmodernist perspective which challenges the traditional process of hypothesising. This postmodern challenge is in part due to the use of the term ‘hypothesising’ which is strongly associated with reductionism or structuralism, which relies on the scientific method. As a clinical activity, the actual process of hypothesising is a complex, cognitive task and often a relatively unpopular activity which is difficult to teach to students. This paper discusses the therapeutic benefits and limitations of hypothesising and proposes a structure for teaching hypothesising to students learning to work with couples from a post-Milan perspective.     

Plural analysis: Multiple approaches to quantitative research

The dominant approach to decision analysis in particular, and quantitative research in general, issingular, i.e., all conclusions are based on a single preferred model or approach. Inplural analysis, several singular analyses are pursued in parallel, the typically conflicting results are merged. Although it is a central feature of intelligent everyday thinking, plural analysis has largely been ignored by the research community. This paper reports on an ongoing, multidisciplinary, research program, supported by the National Science Foundation and the Office of Naval Research, to establish guidelines, grounded in defensible theory, for designing a plural analysis strategy (where appropriate) and integrating the results of analysis.     

Clinical social work with chicanos: Some unwarranted assumptions

Generally the literature of social work conveys a negative attitude toward the use of clinical social work with Chicanos. These attitudes result from assumptions that have not been empirically tested. Nevertheless these assumptions have been accepted as valid. This paper identifies and discusses these assumptions in the light of the nature of clinical social work and its objectives. The conclusion reached is that clinical social work is not alien to the needs of Chicanos and can be used successfully with them when the therapist has an understanding of the cultural system and can provide therapy within its framework.     

Resisting the pull of the health insurance tarbaby: An organizational model for surviving managed care

Insurance company managed mental health care makes a basic change in the clinical process, transforming what had been a therapeutic dyad into a three-party process. The newly formed San Fernando Valley Alliance of Mental Health Professionals for the Preservation of Privacy and Self Determination in Psychotherapy seeks to preserve the practice of traditional psychotherapy and keep it accessible to a middle-income clientele by a public education process in which the privacy and autonomy of the therapeutic dyad are presented as thesine qua non of psychotherapy.     

Improving the quality of life: Prescriptions for change

The main points made in the previous papers are summarized and integrated and the strategies that the authors have recommended for producing an improved QOL are discussed. QOL is also systematically reviewed in relation to matters of definition, assessment, applications, and directions for future research and practice.