Training with o (observing) and T (treatment) teams in live supervision: reflections in the looking glass*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams' own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.     

Student desires for a university drug education program

A questionnaire was designed to determine the type of drug education program most desired by undergraduate students attending a major university. The survey was to provide the basis for a comprehensive drug education program. The 101 item questionnaire elicited responses from 656 undergraduates in categories ranging from knowledge base to credible information sources. The analysis of student desires as they relate to program design is included in this article. The students strongly believed the university should provide a drug education program. In particular they desired a credit course dealing with both drugs and alcohol. They also wanted regularly published articles on drugs in school publications. The most credible knowledge sources were PhDs and MDs. Students also wanted contact with former drug users. More than half the students believed that values clarification and "coping skills" training would decrease their drug use. In general more women than men were likely to utilize such resources.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

The developmental implications of migration from and between small island nations

This article discusses the role of migration in relieving population pressures, thus making continuing development possible, using small nations in the Caribbean and the South Pacific as examples. The Caribbean islands and many Pacific islands have used out-migration to ease population pressures in this century. Surplus labor has been emerging in various Caribbean nations, independent of the international marketing problems of plantation agriculture. Rural populations alienated from plantations have had to make do on questionable and/or remote land. Population surpluses appear to originate in rural areas, but little evidence exists to suggest that those surpluses are the basis for the emigration patterns of the Caribbean islands. Emigration does not solve population problems because when ambitious, skilled workers leave their country, their actions have little to do with the existence of domestic surplus labor and their leaving may do little to facilitate domestic labor absorption. Thus, if mini-states wish to sustain their hopes of economic expansion, they must find the means to employ their surplus labor. Since mainly skilled migrants leave, their going may actually slow development and retard opportunities for labor absorption. Population movements internal to the Caribbean region may further complicate surplus labor and/or population problems. If protective entry requirements impede normal inter-island relations, they may interfere with developmental processes. In general, migration is not a feasible strategy for population control for small island nations. While temporary migration has a more positive impact than other forms of migration, problems do exist. For example, temporary migration 1) can impose significant economic costs on the source-country, and 2) may result in the source country being unable to capitalize on its initial investment in training and education of temporary migrants. In conclusion, import substitution through cooperation between small island nations, production for export where feasible, and more attention to more sophisticated international service linkages hold a better prospect for material progress than relying on the export of surplus populations.     

Compulsive gambling and the medical model

The medical model as a conceptual and operative approach to compulsive gambling is discussed. The terms medical model and disease are defined and the practical implications of their application to compulsive gambling are explored. Special attention is given to the addictive disease concept. Finally, a variety of objections to the medical model are described, but it is concluded that the many individual and social advantages of the medical model make it the preferred conceptualization at our present state of knowledge.     

Evidence for a common dissociative-like reaction among addicts

A questionnaire was designed to test selected aspects of the author's General Theory of Addictions (Jacobs, 1982). Data were collected from groups of compulsive gamblers, alcoholics, and compulsive overeaters, and compared with the responses to the same questionnaire obtained from normative samples of adolescents and adults. The more inclusive term, compulsive gambler, has been used throughout, since the sample of gamblers in this study included an inpatient subgroup who had been diagnosed as pathological gamblers, as well as a subgroup of Gamblers Anonymous members who had not been clinically evaluated. Findings support the author's theoretical position that, when indulging, different kinds of addicts will tend to share a common set of dissociativelike experiences that differentiate them from nonaddicts. This has been termed a state of altered identity.     

Interpreting demographic effects in duration analyses of first birth intervals

Estimated demographic effects in proportional hazard models of first birth intervals could reflect time-invariant differences in the risk of a birth, or differences in the timing of a shift in the risk, or both. This paper attempts to distinguish between these possibilities. The procedure is to estimate a more general model than the proportional hazard specification, in which the evolution of the risk of a birth can differ with demographic characteristics. The proportional hazard specification is nested within this more general model. Consequently, the consistency of the data with the risk or the timing interpretation of demographic effects can be tested. The data studied do not lead to a rejection of the proportional hazard specification.Department of Economics, University of Pennsylvania. The initial stage of this research was supported by a National Science Foundation Graduate Fellowship. I have benefited from insightful comments from David Bloom, Andrew Foster, Zvi Griliches, V. Joseph Hotz, Duncan Thomas, anonymous referees, and participants in seminars at Harvard University and the University of Pennsylvania, and in the Economic Demography sessions of the 1988 Population Association of America annual meetings. Any remaining errors are my own.     

Elective single mothers and their children: The missing fathers

Elective single mothers are adult, unmarried women who intentionally become mothers. This study utilized longitudinal data about 17 Caucasian, elective single mothers and their children to identify fathers' roles in these families, and to understand children's views of their fathers. These single mothers and their children resided for the first six years of the children's lives in father-absent households. By age six, most of the children had ghost fathers, whom they had never met or knew little about. The data suggest that the father often becomes a family secret, and that children may blame themselves for their fathers' absence.     

Demography and ageing -- a truism highlighted

Since the aging of populations, with its extensive consequences, requires ample planning, demography is the soothsayer of gerontology. The realization that aging is the main demographic event of this century has generated an interdependence among demography, gerontology, and geriatrics, and created a base from which to extrapolate socio-political consequences from population changes. Demography transforms the personal unidimensional experience of aging to a dynamic one which traverses time and geography. Chronological age is not an exclusive criterion; this presents an opportunity to explore avenues grounded in the realms of economics, politics, policy, and culture. The inclusion of demography in international training courses of the International Institute on Aging (United Nations-Malta) has made possible an easier progression toward discussing policy, planning, funding, and social services within a broader context. The dependency of aging upon demography established the collaborative development between the Committee for International Cooperation in National Research in Demography (CICRED) and INIA and the joint hosting of a synthesis meeting on Population Ageing Research Project. In this collection of papers, Don Rowland creates the concept of the Gerontological Transition which interprets aging as a process of cohort flow; Raul Hernandez, through an evaluation of regional data, provides a classic analysis of changing age ratios within the population as a whole; Anthony Warnes, through use of mortality rates, provides a demographic analysis to expose the age-dependent variability in health and welfare payments; Paul Paillat transposes demographic numbers into social consequences; Miroslav Macura focuses on the youth in these population shifts; and the emerging elderly in the never ending cycle of events are viewed. Planning beyond the individual lifetime will become a necessity for mankind.     

Sucker bet or sure thing: A critical analysis of sports lotteries

A paradox currently exists regarding legal sports gambling in North America: various forms are flourishing in Nevada, Oregon, and several Canadian provinces, while at the same time the United States Congress is conducting hearings on two bills that would prohibit any new state-sponsored sports gambling initiatives. This study examines the issue of why some jurisdictions are enthusiastic about legal sports gambling while others strongly resist the concept. In reviewing these divergent viewpoints, a case study of the newfledged Canadian Sport Select gambling format is presented. This example is used to highly the perils and payoffs of a typical state-sponsored sports gambling scheme, with a view toward broadening our understanding of how they work and how they might be fairer to the public.