Family-based approach to the child welfare system: an integration of Bowen family theory concepts

The purpose of this article is to apply Bowen family systems theory to work with families involved in the child welfare system. An overview of family systems theory is provided, and then specific tenets of Bowen family systems theory are presented. The authors highlight incidents within the child welfare setting that can be conceptualized through Bowen family therapy terms and concepts. A case study is used to highlight how this theory could be applied in practice. Furthermore, recommendations for child welfare practice and policy implications are discussed, utilizing the lens of a Bowenian family systems approach.     

Evaluation of an Innovative Tool for Child Sexual Abuse Education

Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse. The current research demonstrates a unique approach to promoting awareness and stimulating discussion about child sexual abuse. Qualitative methods have rarely been used to study child sexual abuse prevention. Qualitative inductive analyses of interviews from 20 key informants identified both positive and negative assessments with six emergent themes. The themes revealed inherent tensions in using narrative accounts to represent the complex cultural context within which child sexual abuse occurs. More research is needed, but the program shows potential as a methodology to raise awareness of child sexual abuse.     

Post-Traumatic Stress Disorder,Dissociation, and Neuropsychological Performance in Latina Victims of Childhood Sexual Abuse

This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.     

Adverse Childhood Experiences and Healthcare Costs in Adult Life

ABSTRACT

The current study aims to present the prevalence of adverse childhood experiences and examine the healthcare costs associated with primary, allied, and specialist healthcare services. The Australian Longitudinal Study on Women’s Health is a general health survey of four nationally representative age cohorts. The current study uses 20 years of survey and administrative data (1996–2015) from the cohort born 1973–1978. Overall, 41% of women indicated at least one category of childhood adversity. The most commonly reported type of childhood adversity was having a household member with a mental illness (16%), with the most commonly reported ACES category being psychological abuse (17%). Women who had experienced adversity in childhood had higher healthcare costs than women who had not experienced adversity. The healthcare costs associated with experiences of adversity in childhood fully justify a comprehensive policy and practice review.     

Stigma,AIDS, and HIV Prevention in Africa: Reports from Community Organizations Providing Prevention Services

ABSTRACT

The AIDS epidemic in Africa remains a serious health crisis. Nongovernmental organizations (NGOs) in Africa play a critical role in the delivery of HIV prevention services. An important barrier to their HIV prevention efforts is stigma directed at persons living with HIV/AIDS. In order to understand how stigma affects HIV prevention programming, we conducted in-depth qualitative interviews with NGO directors in 29 African countries. Qualitative analytic approaches were used to identify key themes. Substantial discrimination and stigmatization of HIV-positive persons was reported. HIV-positive women were particularly likely to suffer negative social and economic consequences. The stigma associated with HIV interfered with disclosure of HIV status, risk-reduction behaviors, and HIV testing, creating significant barriers to HIV prevention efforts.

Interventions to reduce AIDS-related stigma in Africa are urgently needed. Reducing the burden of stigma is critical to fighting the epidemic in Africa and could play an important role in global HIV reduction.     

Photo‐documenting the needle exchange: methods and ethics

When research subjects are people with stigmatized identities, then special consideration must be given to their desire for privacy and anonymity. This is especially true when photographs constitute the recorded data. This paper discusses some challenges in conducting research in a needle exchange located in a small city. Within the needle exchange, the camera posed a threat to drug users who preferred to remain anonymous, if not invisible. Ethical considerations and emotional frustration, stemming from the need and desire to get photographs of clients while respecting their obvious desire for privacy, are discussed. The practical difficulties associated with getting photographs and some methods for facilitating interaction with clients are also presented.     

Book reviews

New scholarship on rape in American history

Sex Without Consent: Rape and Sexual Coercion in America. Edited by Merril D. Smith. New York: New York University Press, 2001, 308 pages. Cloth, $60.00; paper, $19.50.

The enigma of sexual desire

Sexual Appetite, Desire and Motivation: Energetics of the Sexual System. Edited by Walter Everaerd, Ellen Laan, and Stephanie Both. Amsterdam, Netherlands: Knaw Edita, 2001, 156 pages. Paper, NLG 80.00, Euro 36.30.

American sex in the private and public sectors

Sex, Love, and Health in America: Private Choices and Public Policies. Edited by Edward O. Laumann and Robert T. Michael. Chicago, IL: The University of Chicago Press, 2000, 535 pages. Hardcover, $48.

Enlarging the landscape of sexual pleasure

Good Sex: Feminist Perspectives from the World's Religions. Edited by Patricia Beattie Jung, Mary E. Hunt, and Radhika Balakrishnan. New Brunswick, NJ: Rutgers University Press, 2001, 220 pages. Cloth, $50.00; paper, $20.00.

Another stab at sexual theory

The Role of Theory in Sex Research. Edited by John Bancroft. Bloomington, IN: Indiana University Press, 2000, 366 pages. Cloth, $49.95.     

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women’s own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being.     

Promoting tolerance for homosexuality: An evaluation of intervention strategies

This article presents a methodological critique of the few attempts to promote tolerance for homosexuality through education. The d statistic was utilized to assess the extent of attitude change from pre‐ to post‐intervention assessment. With few exceptions, data have been gathered from college students in courses focused on human sexuality. These data suggest that students who complete these courses become less fearful of contact with homosexuals, more tolerant of homosexuals in social roles, and more tolerant of homosexual behavior, although the extent and duration of the changes may be limited. Although some attribute attitude change to the intensiveness of the course, methodological and conceptual problems, including volunteer bias, provide alternative explanations. Further attempts to promote tolerance toward homosexuality must consider differences in attitudes toward gay men and lesbians and the extent to which men and women differ in their level of tolerance toward these groups.     

American Migrants in Australia: An Exploratory Study of Adjustment

Abstract

In the literature on American migration to Australia, there is a debate concerning the ease and degree of post-migration social-psychological adjustment. In this paper a model of migrant adjustment is derived from the literature; relationships among social psychological measures of adjustment (alienation, work orientations, amicability, isolation, and missing family and friends) and socio-demographic variables are analyzed using path analysis. Results tend to support a complex view of migrant adjustment based on differences in socio-demographic characteristics. Certain modifications to existing literature are recommended, and avenues for further research are suggested.