Following the River’s Flow: A Conversation about Single Session Approaches with Aboriginal Families

Alison Elliott and James Dokona were interviewed by Henry von Doussa, and this article is the written version of that interview. In it, Alison and James separately refer to issues such as early skepticism about the applicability of a single session therapy approach with Indigenous families (Alison), a growing experience of its ‘fit,' philosophically and culturally, and the hope that can be engendered in one conversation. They underline the importance of the oral tradition, and other cultural concepts such as Dadirri (deep listening) as well as the trauma-informed principles of choice, collaboration, and empowerment, through using their language, asking permission, working together on solutions, and not coming across as an expert. The article is infused with the practical ideas and the values inherent in the authors’ work, including permission-seeking, reflection, containment, and their use of a whiteboard as a resource to capture multiple perspectives, a genogram (including pets), and to facilitate yarning. The flow of this conversation in itself reflects James’ imagery of the therapeutic conversation being like a river running – you don’t know which way it’s going to go.     

USE OF EXPERT RATINGS AS SAMPLING STRATA FOR A MORE COST-EFFECTIVE PROBABILITY SAMPLE OF A RARE POPULATION

We consider situations in which externally observable characteristics allow experts to quickly categorize individual households as likely or unlikely to contain a member of a rare target population. This classification can form the basis of disproportionate stratified sampling such that households classified as "unlikely" are sampled at a lower rate than those classified as "likely," thereby reducing screening costs. Design weights account for this approach and allow unbiased estimates for the target population.We demonstrate that with sensitivity and specificity of expert classification at least 70%, and ideally at least 80%, our approach can economically increase effective sample size for a rare population. We develop heuristics for implementing this approach and demonstrate that sensitivity drives design effects and screening costs whereas specificity only drives the latter. We demonstrate that the potential gains from this approach increase as the target population becomes rarer. We further show that for most applications, unlikely strata should be sampled at 1/6 to ? the rate of likely strata.This approach was applied to a survey of Cambodian immigrants in which the 82% of households rated "unlikely" were sampled at ? the rate as "likely" households, reducing screening from 9.4 to 4.0 approaches per complete. Sensitivity and specificity were 86% and 91% respectively. Weighted estimation had a design effect of 1.26 so screening costs per effective sample size were reduced 47%. We also note that in this instance, expert classification appeared to be uncorrelated with survey outcomes of interest among eligibles.     

The encounter with family violence and risky sexual activity among young adolescent females

In this article, we analyze the relationship between family violence and risky sexual activity for female adolescents (age 14 to 17). We examine two forms of family violence: experience (receiving physical abuse from a parent or parent-figure) and exposure (witnessing interparental physical violence). We hypothesize that either form of violence will predict greater odds of engaging in risky sexual behavior. We define risky sexual activity as any of the following: having multiple partners within the last 12 months or having sex with partners who are themselves engaging in risky behavior (e.g., having multiple partners of either sex, injecting unprescribed drugs, sharing unprescribed needles for injecting drugs). We analyzed data from 710 respondents taken from the National Survey of Family Growth, Cycle V, living with at least one biological parent. Results showed that experiencing violence from a parent greatly increased the likelihood of risky sex, even when controlling for the experience of forced sex, age, mother's age at first birth, race, socioeconomic status, and religiosity. Female adolescents who had experienced forced sex, those who were older (especially 17-year-olds), non-Hispanic Blacks (but not Hispanics), those living in a family with low educational attainment (less than a high school diploma), and those for whom religion was not or only somewhat personally important were more likely to report risky sex compared to others. These effects were not modified by whether the respondents lived in single- or two-parent families. An interaction between the two forms of physical violence suggests that either form is sufficient to increase significantly the odds of risky sex; an analysis in which respondents were differentiated by their experience of either form of violence showed a strong effect of experience on risky sex, net of the control variables.