Spiritual issues in family therapy: a graduate-level course

With the advent of the biopsychosocial approach in family therapy, the domain of spiritual issues is increasingly being recognized as important to families. This article will describe a graduate-level seminar on Spiritual Issues in Family Therapy at the University of San Diego that offers family therapy students the opportunity to examine issues of spirituality, religion, and meaning and their place in therapy. One premise of the course is that research has demonstrated that most clients consider their spiritual life to be relevant to personal problems and would prefer a therapist who is comfortable with such topics. The goals of the course include (1) training in opening a dialogue with individuals and families about spiritual issues and discerning when referral may be appropriate; (2) expanding an awareness of wisdom traditions through use of comparative religions material; and (3) identifying from current practice many of the spiritual issues that may arise in the clinical setting.     

Decrease in restraint use in a study of a geropsychiatric unit

1. Traditional and nontraditional interventions were used in this study. 2. There was a reduction in the number of times restraints were used, as well as in the number of patient placed in restraints. 3. Further research is needed to find more humane ways to help older adults through acute crisis episodes.     

An evaluation of a client-centered case management program for elder abuse

ABSTRACT Short-term outcomes of a case management program for competent, community-dwelling abused elderly persons were assessed. The intervention provided by Case Managers consisted of five components: (a) helping the client set long and short-term goals, (b) providing information about services and legal rights, (c) explaining and discussing options to decrease abuse, (d) supporting the client in deciding to take action or not, and (e) involving others in the plan of care. Retrospective data were collected from 26 client records. Intervention outcomes were assessed by determining the number of cases in which abuse was eliminated or decreased at case closure and the reasons for case closure. In 34.6% of the cases, abuse was completely eliminated, while in 30.8% of cases there was some improvement in the situation.     

Abuse during and before pregnancy: prevalence and cultural correlates

This study examined the prevalence of abuse during pregnancy and the influence of cultural norms and acculturation on abuse in 1,004 Mexican American, Puerto Rican, Cuban American, Central American, African American and Anglo American women. Women were recruited from consecutive delivery logs in general community hospitals in Florida and Massachusetts. The Index of Spouse Abuse and the Abuse Assessment Screen ascertained history of adult physical, sexual, and emotional abuse, abuse during pregnancy, and childhood sexual abuse. An Interview Protocol assessed cultural attitudes, acculturation, and demographic information. Hispanic American women, as a whole, did not differ significantly from Anglo American women in their prevalence of abuse during pregnancy, after controlling for sociodemographic variables. However, Cuban American and Central American partners were significantly less likely to abuse their pregnant partners than were other groups even after adjustment. Women who spoke only Spanish (less acculturated) were less likely to report physical abuse from their partners both before and during pregnancy. Cultural norms, such as a partner's belief in wife/mother role supremacy and cultural group acceptability of men hitting women, were significantly positively related to both physical and emotional abuse. Other risk factors for abuse were the abuser not being the biological father of the baby, low income and little education, and being unmarried.     

Will Australian workers' compensation insurance management get better soon?

A study of Australian experience in the state of New South Wales (NSW) suggests that private sector underwriting of workers' compensation insurance risk plus insurer competition on premium price may put downward pressure on benefits for injured workers, inhibit rehabilitation, and cause related cost increases for taxpayers and employers. Insurer underwriting also increases workers' compensation administrative costs and means an unnecessary loss of investment income for government and industry. An emerging and better alternative for the Australian community is for government and industry to underwrite a national workers' compensation scheme and to fix premium and benefit requirements which are competitively administered by insurers. In such a regulatory environment insurer inability to compete on premium price should promote competition to provide effective services to help employers prevent injury, assist rehabilitation and contain cost. National standards are necessary to enable widespread dissemination of comparable, reliable information on the outcome of health, rehabilitation, dispute resolution and return to work services. This is required to assess the competitive performance of service providers in order to ensure effective operation of the market to achieve scheme objectives. Holistic, multi-skilled and objective rehabilitation professionals are needed who can clearly demonstrate the effectiveness of their actions in assisting injury prevention, worker rehabilitation, and safe return to work across a range of industry contexts.     

Perceived Availability,Risks, and Benefits of Gambling among College Students

The current study was an exploration of gambling-related perceptions and their relation to gambling behavior among young adult college students. Three hundred and two ethnically diverse undergraduates at a large urban public university completed a survey to assess their perceptions of the availability, risks, and benefits of gambling, and the South Oaks Gambling Screen (SOGS) to assess gambling behavior and problems. Participants generally rated gambling as more available than alcohol or marijuana, and less risky than alcohol or cigarettes. The most common perceived benefits of gambling were social enhancement, financial gain, and positive changes in affect. Perceived benefits were a significant predictor of gambling problems. Perceived availability, perceived risk, and perceived benefits were found to be significant predictors of regular gambling. These results provide valuable information about the ways that college students perceive gambling and demonstrate that perceptions can be important predictors of gambling behavior. An erratum to this article can be found at     

The South Oaks Gambling Screen-revised Adolescent (SOGS-RA) Revisited: A Cut-point Analysis

The lack of a criterion validity gold standard defining adolescent pathological gambling represents a major limitation of the adolescent gambling literature. The present study employed Receiver Operating Characteristic curve analysis (ROC) to examine the performance of the South Oaks Gambling Screen-Revised Adolescent (SOGS-RA) recommended cut-point of 4 against two-proxy gold standards: self-identified need for, or receipt of, help for gambling. Logistic regression analysis examined the correlates of self-identified need for help with gambling. The sample was comprised of 12990 adolescents from Atlantic Canada whose average age was 15 years and 50% of whom were male. The SOGS-RA performed as well or better with these proxy gold standards than with proxies used in previous studies. We concluded that the proxy gold standards based on self-identified need for or receipt of help represent a pragmatic solution to the lack of an adolescent-specific definition of problem or pathological gambling. Students in grade seven and SOGS-RA scores of 4 or greater were independent predictors of self-identifying a need for help.     

An ecological approach to facilitate successful employment outcomes among people with multiple chemical sensitivity

Many adults with multiple chemical sensitivity (MCS) must prematurely exit the workforce because of the severity of their MCS symptoms, the resulting disability stigma, and their unmet needs for on-the-job accommodations. To help individuals with MCS continue working or re-enter employment, rehabilitation professionals must understand the barriers resulting in unemployment and implement interventions to reduce or remove those barriers. In this article, the Ecological Model of Career Development is presented as a scheme for identifying barriers and implementing rehabilitation interventions to improve the employment outcomes among people with MCS.     

Employment after spinal cord injury: the impact of government policies in Canada

The British Columbia Paraplegic Association (BCPA) sought a research partnership to evaluate where its activities should be focused. A survey of members with disabilities of the BCPA included questions on employment and identified three priorities related to employment. These were the need for assistance in finding appropriate work, the impact of policies of government and insurance agencies, and attitudes of employers. This paper examines the social and political environment related to employment following spinal cord injury in British Columbia, Canada. There is no coherent set of goals underlying government employment and income programs in Canada. Incremental development of particular employment and income programs during the 20th century led to a patchwork of policies and programs, which deal with people differently according to the cause of their disability. Federal and provincial governments have attempted to educate employers and reduce barriers to employment of those with disabilities by focusing on anti-discrimination legislation and individual rights (e.g. the Employment Equity Act and the Canadian Human Rights Act). However, people with disabilities face non-accommodating environments, inadequate income support, lack of opportunities and little political influence which stem from an unfair distribution of societal resources, not from discrimination. Joint efforts of the BCPA and other disability organizations are likely to have the most impact on legislative changes.