Group therapy as primary treatment for adolescent victims of intrafamilial sexual abuse

This article describes the therapeutic needs of adolescent victims of sexual abuse and presents the case that group therapy more effectively addresses these needs than individual or family therapies.     

Best Practice Options: Albania

The Cooperative Efforts to Manage Emigration (CEME) site visit to Italy and Albania – organized in cooperation with the Centro Studi di Politica Internazionale (CeSPI), an Italian independent research institute – took place in June 2002. Albania is a country of 3.1 million people with a GDP of $4.1 billion that switched in the early 1990s, after 45 years of communism, from economic autarky to a peculiar form of market economy, and experienced some of the world’s highest emigration rates in the 1990s. Some 600,000 to 700,000 Albanians, or almost one–fourth of Albanians, and half of Albanian professionals, emigrated. As a result, the labour force is only 38 per cent of the population, versus 50 per cent in most industrial countries (UNDP, 1996, 2000). The major destinations of Albanian migrants in the 1990s were Greece, which had 400,000 to 600,000 Albanians in 2002, and Italy, which had 144,000 legal residents and probably some tens of thousands illegals at the end of 2001. 1 The Albanian Government estimates that about half of the Albanians in Greece are legal residents. There are also about 100,000 Albanians in Switzerland, the UK, Germany, and other Western European countries.
Many Albanians have become legal residents of Greece and Italy as a result of regularization–legalization programmes. Albania is also a transit point for third country nationals attempting to reach the rest of Europe via Albania. Of particular interest to the CEME members were efforts by the Italian and Albanian governments to cooperate in managing the flows of Albanian and transit migrants. When the CEME visit was made, Albania was experiencing rapid, yet unbalanced economic growth as a result of $615 million in remittances from Albanians abroad (estimates: Bank of Albania annual report, 2001), and aid from the European Union (EU) and other sources. The spending of remittances and aid has fuelled a building boom, but there was no clear sense of how Albania would use the window of opportunity opened by remittances and aid to develop a viable economy. The optimistic scenario is that remittances and investments from Albanians abroad will produce an economic take off based on value–added food production and tourism in the “Switzerland of the Balkans”. The pessimistic scenario is that corruption and divided government will prevent the development of a successful economic strategy, and that low wages, high unemployment, and inadequate services such as health care and education will prompt the continued emigration of young and educated Albanians. Potential best practices include: joint Italian–Albanian marine patrols to discourage smuggling and trafficking in small “fast boats”; Italy granting Albania at least 6,000 work visas a year to publicize that there is a legal way to work in Italy, helping to discourage illegal migration; and bilateral and international assistance to enable Albania to develop laws and institutions to deal with foreigners transiting Albania, and foreigners requesting asylum in Albania. Albania does not, on the other hand, appear to be a best practice in managing the use of remittances to aid economic development. Although remittances play an important role in basic subsistence and construction of housing, there have been fewer efforts to encourage investment of these funds in infrastructure or productive activities. The banking system needs substantial reform to become a venue for transfer of remittances and source of credit for enterprise development. Albania would benefit from a more systematic examination of the lessons learned in other countries about the investment of remittances for economic development.     

Older children in preadoptive homes: issues before termination of parental rights

In many jurisdictions, after the end of reunification services to birthparents, but before termination of parental rights, children are placed with parents who are licensed as foster parents but are committed to adopting the child. Using case examples, this article discusses the emotional and psychological difficulties often encountered by children and their prospective adoptive parents when birthparent visitation takes place and legal uncertainties exist. In addition, this article offers clinical and policy recommendations to help both the children and families in these situations as well as the professionals who work with them.     

Sexual satisfaction in premarital relationships: associations with satisfaction,love, commitment,and stability

This investigation focused on how sexual satisfaction is associated with relationship quality and stability in premarital couples. With data collected at multiple times over several years from a sample of heterosexual couples (who were all dating at Time 1), we examined how sexual satisfaction was associated with relationship satisfaction, love, commitment, and stability. At each wave of the study, sexual satisfaction was associated positively with relationship satisfaction, love, and commitment for both men and women. In addition, change in sexual satisfaction between Time 1 and Time 2 was associated with change over the same period in relationship satisfaction, love, and commitment. Furthermore, some evidence was found that sexual satisfaction was associated with relationship stability. Overall, sexual satisfaction had stronger links with relationship quality for men than for women.     

Couple dynamics and attributions when one partner has an acquired hearing loss: implications for couple therapy

We discuss the communication difficulties that many couples face when one partner has a hearing loss. We also discuss the role of attribution theory in understanding the marital distress of these couples. Finally, we offer interventions to support better communication between couples facing the challenges of hearing loss.     

Emotionally focused interventions for couples with chronically ill children: a 2-year follow-up

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT.     

The Role of Geographic Scale in Monitoring Environmental Justice

Utilizing the concept of environmental justice, this paper examines the differential burdens of toxic and hazardous waste facilities locations in low income minority communities. The association between the presence of facilities and socioeconomic characteristics of places are examined for the state of South Carolina at three different spatial scales: counties, census tracts, and census block groups. Three different types of hazardous waste/toxic facilities are also examined: Toxic Release Inventory (TRI) sites, Treatment, Storage, and Disposal sites (TSD), and inactive hazardous waste sites. At the county level, there was some association between the presence of toxic/hazardous waste facilities and race and income. In South Carolina, this translates to a disproportionate burden on White, more affluent communities in metropolitan areas, rather than low income minority communities. At both the census tract and block group levels, there is no association between race and the location of toxic/hazardous waste facilities. There are slight differences in the income levels between tracts and block groups with facilities and those without. This localized ecology of hazard sources must be expanded to include emission/discharge data in order to adequately address environmental justice issues on who bears the burdens of environmental contamination.     

Route-to-Route Extrapolation of the Toxic Potency of MTBE

MTBE is a volatile organic compound used as an oxygenating agent in gasoline. Inhalation from fumes while refueling automobiles is the principle route of exposure for humans, and toxicity by this route has been well studied. Oral exposures to MTBE exist as well, primarily due to ground-water contamination from leaking stationary sources, such as underground storage tanks. Assessing the potential public health impacts of oral exposures to MTBE is problematic because drinking water studies do not exist for MTBE, and the few oil-gavage studies from which a risk assessment could be derived are limited. This paper evaluates the suitability of the MTBE database for conducting an inhalation route-to-oral route extrapolation of toxicity. This includes evaluating the similarity of critical effect between these two routes, quantifiable differences in absorption, distribution, metabolism, and excretion, and sufficiency of toxicity data by the inhalation route. We conclude that such an extrapolation is appropriate and have validated the extrapolation by finding comparable toxicity between a subchronic gavage oral bioassay and oral doses we extrapolate from a subchronic inhalation bioassay. Our results are extended to the 2-year inhalation toxicity study by Chun et al. (1992) in which rats were exposed to 0, 400, 3000, or 8000 ppm MTBE for 6 hr/d, 5 d/wk. We have estimated the equivalent oral doses to be 0, 130, 940, or 2700 mg/kg/d. These equivalent doses may be useful in conducting noncancer and cancer risk assessments.