Helping families where parents misuse drugs or alcohol? A mixed methods comparative evaluation of an intensive family preservation service

Option 2 is an intensive family preservation service for families with serious child protection concerns related to parental misuse of drugs or alcohol. A previous evaluation indicated that it reduced the number of children entering care and, as a result, produced cost savings; however, little data were gathered from families. This study involved interviews with 15 families (46 children) who had received the service, and a comparison group of 12 families (28 children) referred but not provided the service due to no workers being available. Outcomes and experiences were compared, on average, 5.6 years following referral. Findings included a significant reduction in children entering care, and improvements in relation to substance misuse, parental well‐being and family cohesion. There was no difference in emotional and behavioural welfare of children. Qualitative accounts were very positive about the impact of the service, identifying effective engagement of parents and key elements of good practice in supporting families to change. The findings provide additional support for suggesting that high quality, intensive interventions with families affected by parental substance misuse can be effective. Key lessons for current attempts to deal with the increase in children entering care and the English government's ‘troubled families’ initiative are considered.     

Vaginal Dryness and Beyond: The Sexual Health Needs of Women Diagnosed With Metastatic Breast Cancer

While research on the sexual health of women with early stage cancer has grown extensively over the past decade, markedly less information is available to support the sexual health needs of women diagnosed with advanced breast cancer. Semistructured interviews were conducted with 32 women diagnosed with metastatic breast cancer (ages 35 to 77) about questions they had concerning their sexual health and intimate relationships. All participants were recruited from a comprehensive cancer center at a large Midwestern university. Three themes were examined: the role of sexual activity and intimate touch in participants' lives, unmet information needs about sexual health, and communication with medical providers about sexual concerns. Findings indicated that sexual activities with partners were important; however, participants worried about their own physical limitations and reported frequent physical (e.g., bone pains) and vaginal pain associated with intercourse. When women raised concerns about these issues in clinical settings, medical providers often focused exclusively on vaginal lubricants, which did not address the entirety of women's problems or concerns. In addition, women diagnosed with metastatic breast cancer reported needing additional resources about specialized vaginal lubricants, nonpenetrative and nongenitally focused sex, and sexual positions that did not compromise their physical health yet still provided pleasure.     

Stepfamily childbearing in Sweden: quantum and tempo effects, 1950-99

Several studies have demonstrated that stepfamily couples have a higher risk of childbearing than couples in a stable union with the same total number of children. Analysing retrospective data from a nationally representative sample of Swedish adults, we find that the risk of a second or third birth is higher when it is the first or second child in a new union. We also find a faster pace of childbearing after stepfamily formation than after a shared birth. The risk of a second birth (in total) is only a little higher in the first two years after stepfamily formation than in the first two years after a shared birth, and thereafter the risk is lower for stepfamilies. The risk of a third birth (in total) is particularly high early in the stepfamily union and remains higher than that of couples with two shared children for at least five years. The stepfamily difference was lower after than before 1980, when the Swedish government introduced parental leave incentives for short birth intervals.     

Open access family centres and their users: positive results,some doubts and new departures

This article reports findings from a research study of two open access, multi-use, community-based family centres. Structured, qualitative interviews were conducted with 40 adult users and 40 local adult non-users of the two centres. Additionally, a profile of user characteristics was derived from a survey of users attending over a one-week period at both centres. The vast majority of users were women in their twenties, just over half of whom attended with their children. The benefits and limitations of the current functioning of open access centres are discussed, with a potential shift in emphasis along a social development model proposed. Copyright © 1999 John Wiley & Sons, Ltd.     

Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale

ABSTRACT

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to develop methods of measuring how significant others contribute to the treatment and recovery process. In this study, the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for Family Behavior Therapy by CPS. The Significant Other Support Scale (SOSS) was empirically developed and subsequently utilized to assess the extent to which participants’ significant others were perceived by treatment providers to support the participants’ goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results, including methods of using SOSS scores to assist family-based treatments.     

Listening to Children in Care: A Review of Methodological and Theoretical Approaches to Understanding Looked after Children’s Perspectives

This article reviews 44 refereed journal articles published between 2003 and 2008. All of the articles attempt to directly uncover the experiences or perspectives of young people cared for by the state in foster, residential or kinship care homes. The review reveals that this field is developing a rich body of evidence derived from a broad range of methodological and theoretical frameworks. In this sample, research designs appeared to be influenced by placement settings, as well as theoretical orientations, but comparative and longitudinal designs were used in both quantitative and qualitative studies. Participative research designs were only present in qualitative designs within a broadly interpretive theoretical orientation. It is suggested in this article that researchers should critically reflect on the use of constructs that may negatively label young people in care. It is also suggested that there could be fuller reporting of ethical issues. Despite some identified gaps, such as the participation of young people in quantitative research designs and research with younger age groups, the article concludes that there appears to be an encouraging emergence of theoretical and methodological diversity in this research area.     

Tipping as risk sharing

Tipping is often dismissed as an exception to the assumption of rational economic agents. This paper describes situations where tipping is, in fact, an effective mechanism for risk sharing and welfare improvement. When risk-averse customers purchase a service with uncertain quality, tipping can reduce the customer's exposure to risk by making part of the price of the service discretionary. These findings help explain why we tend to tip restaurant workers but not retail workers and why some high-risk service providers, such as lawyers and automobile mechanics, are not typically tipped.     

Condom negotiation strategy use and effectiveness among college students

College students may engage in risky sexual behaviors, such as inconsistent condom use, which increase their risk of sexually transmitted infections. This study examined the association between six condom influence strategies (CIS) and reported condom use among a diverse group of college students. Differences in CIS and condom use were examined by gender, race or ethnicity, and relationship status (casual, monogamous, or no current relationship). The study also used a cluster analysis to investigate how the CIS were used relative to one another, and how patterns of CIS use were related to condom use. Results showed interesting differences in CIS use by gender, race or ethnicity, and relationship status. Four patterns of CIS usage emerged, and results suggested that using all CIS frequently and using more assertive CIS may be particularly important for increased condom use. Men reported more condom use than women overall, but results indicated that using CIS were especially vital for increasing condom use for women. Surprisingly, there were no differences in condom use found for race or ethnicity and relationship type. Programs aimed at increasing students' condom use could benefit from promoting and practicing CIS, and recognizing potential differences among demographic groups.