The disability self‐direction movement: Considering the benefits and challenges for an Australian response

The following article provides a snapshot of the current self‐direction movement within the disability sector across the industrialised world, with particular emphasis on the Australian context. As a global movement, self‐direction has been in progress for several decades through a variety of implemented responses. Despite implementation variation, all self‐direction models aim to facilitate individual control and decision making in care and support services. We describe self‐direction, its various models and programs, and explore its benefits and challenges. We conclude by making broad recommendations for decision makers involved in self‐direction. In particular, we offer a hierarchical decision tree that can be used to inform policy decisions at a systems – government policy – and organisational level.     

Rapid Assessment for Psychopathology in a College Health Clinic: Utility of College Student Specific Questions

Abstract

Objective: The purpose of this study was to determine the utility and unique benefits of employing the College Health Questionnaire (CHQ) in a college health care setting. The CHQ is a newly designed measure to assess psychosocial issues commonly problematic among college students. Participants: One hundred nine patients participated in the study during their medical appointments. Methods: Participants completed the study questionnaires (CHQ and Patient Health Questionnaire) in the waiting room. Their provider had the opportunity to use the responses in treatment decision making. Results: A majority (66.1%) endorsed at least one CHQ item. Patients who indicated traditional mental health problems were more likely to be prescribed psychotropic medications, whereas patients who endorsed psychosocial issues commonly problematic among college students were more likely to be referred for behavioral treatment. Conclusions: Screening for behavioral problems in college primary care settings without the use of college-related questions would result in missing numerous important psychosocial problems.     

The Function of Avoidance in Improving the Understanding of Disaster Recovery

Functional avoidance as an intermittent coping mechanism is a necessary component in disaster recovery. By temporarily avoiding losses after disaster, survivors can secure basic needs and begin rebuilding. It is not until recovery projects are completed that mental health outcomes become apparent. Many individuals begin a healthy grieving process; however, for others, where avoidance extends past the completion of normalizing tasks it becomes pathological. This study presents the concept of functional avoidance and investigates the point at which it becomes dysfunctional using case examples and data from a mental health clinic. Findings suggest increased emotional distress, depression, and posttraumatic stress disorder over 3 years after Hurricane Katrina.     

Women's Welfare and Social Security Privatization in Mexico

Several Latin American countries have fully or partially privatizedtheir public pensions since the 1980s. In 1995 Mexico privatizedits public pension system, including a shift from a definedbenefit to defined contribution system based on privately administeredindividual accounts. This article uses feminist criteria toevaluate the gender impact of welfare regimes and concludesthat the Mexican pension privatization will have a negativeeffect on women’s welfare in old age.     

Speaking From the Pained Place: Engaging With Frank Dattilio

It was with interest that I accepted the invitation to provide a brief response to Frank Dattilio's article on cognitive restructuring in couples therapy. My reading of the article initially was as a practitioner in couples work for the last 28 years, and who is always curious about what can be helpful with couples. However, I also bring to my reading an understanding of couples work using the framework of the Emotionally Focused Therapy perspective.     

Emotional Abuse in Therapy

This paper presents the experiences of clients who have been emotionally abused in therapy. By this I mean the intentional and unintentional conduct they experienced from therapists towards them that was not in their best interests. By sharing these experiences, I will explore emotional abuse in therapy, how it can be defined, the effects of such on clients and the methods of healing these traumatic experiences. Recommendations will be discussed in the light of this information for practising therapists, professional training and development, standards and ethical committees.