Freud's “Anna O.”: Social work's Bertha Pappenheim

The story of Anna O. has loomed large in psychoanalytic history, but few social workers know that the young woman, who was so influential in the development of Freud's thinking, became a pioneer social worker in Germany. The story of the transformation of the troubled young woman, who was actually Joseph Breuer's patient, is the focus of this paper. In addition, some of the facts of the case are discussed as social constructions. Anna O./ Bertha Pappenheim participated in the creation of the talking cure and eventually went on to be a leading feminist, developer of social programs for women, and social reformer.     

Gambling and the Law®: Endless fields of dreams

This article examines the current trends of proliferation of commercial gaming, especially in the United States, in the context of the third wave of legalization of gambling that has been experienced since the founding of the nation. The author looks at the historic foundations of the spread of casino-style gambling, and notes the types of casino gaming that have led the way in the current expansion. He also points out why it is reasonable to expect that this wave too may come crashing down, as general acceptance of wide-spread casino gaming in America may indeed be short-lived.Gambling and the Law^® is a registered trademark of I. Nelson Rose.     

Zeroing in on leadership effectiveness: The methodological challenges of benchmarking leadership practices

Business success in the 21st century will be based on the widespread mastery of leadership roles, rather than on the directives of a professional or leadership elite. The first step for systematically enacting a leadership development agenda for our nation is to identify the factors, values or qualities most important to leadership effectiveness. Next, we must improve our understanding of how these guiding ideas and insights translate into what successful leaders do. As we perfect this understanding, we will need to operationally define the best practices of successful leaders. These best practices must then become benchmarks for intensive leadership development efforts.This article considers nine methodological challenges of the first agenda item-identification of the factors, values or qualities most important to leadership effectiveness. To illustrate these challenges, the authors use their own business leadership research as a case study. This research surveys 127 chairmen, chief executive officers, and presidents-a cross section of successful U.S.A. business leaders, including men and women from all parts of the nation who have diverse industry, racial, ethnic and religious backgrounds. The authors identify where methodological improvements are needed to cope with the challenges of leadership research. They suggest important directions for methodological development and propose three minimum standards for future leadership research.     

Herding stats: the quality measurement dilemma

All over the country, millions of research dollars are being spent to devise an effective way of measuring quality that could be standardized in health care, and hospitals and managed care companies are experimenting with a variety of quality tools, trying to document what they now can only perceive as improvement. Experts are divided on what works best, but all applaud and embrace the efforts. In this special report, several of them discuss their views on what works, and what doesn't work, in the exploding field of health care quality measurement.     

Keeping the "care" in managed care: the importance of the therapeutic relationship and psychosocial factors in the managed care setting

There is much truth in the adage that "the more things change, the more they stay the same." Nowhere does this seem more apparent than in health care where, amidst monumental reconfiguration, basic foundations of physician-patient relationships and attention to the impact of psychosocial factors on health and health care delivery remain as critical influences. While the importance of the therapeutic relationship and the influence of psychosocial factors in medical care has been clear in traditional systems of delivery, these factors may be even more critical in managed care systems. These emphases must be incorporated by design, however, and not left to default.     

Emigration dynamics of eastern African countries

This examination of emigration dynamics focuses on 13 countries extending from Eritrea to Zimbabwe and Mozambique on the eastern African mainland and on 5 Indian Ocean island nations. The first part of the study looks at the temporal, spatial, and structural perspectives of emigration dynamics. Part 2 considers international migration in the region according to Appleyard's typology (permanent settlers, labor migration, refugees, and illegal migrants) with the additional category of return migration. Measurement issues in emigration dynamics are discussed in part 3, and the demographic/economic setting is the topic of part 4. The demographic factors emphasized include spatial distribution, population density, population structure, population dynamics, demographic transition, and the relationship between internal and international migration. Other major topics of this section of the study are the economic base, the human resource base, population and natural resources, the sociocultural context (emigration, chain migration, return migration, and migration linkages and networks), political factors (including human rights, minority rights and security, regional integration and economic cooperation, and the impact of structural adjustment programs), and a prediction of future emigration dynamics. It is concluded that refugee flows remain a major factor in eastern African countries but the development of human resources in the northern portion of the region indicates development of potential labor migration from this area. Data constraints have limited measurement of emigration in this region and may contribute to the seeming indifference of most eastern African countries to emigration policies. Emigration in this region has been triggered by deteriorating economic and political conditions and is expected to increase.     

Drawing households and other living spaces in the process of assessment and psychotherapy

This paper introduces a drawing technique developed by the author for use in the assessment and treatment of individuals and families. The client is invited to draw a floor plan of his or her home or apartment, or an aerial view of un outdoor area. The drawing is then discussed and considered as a means of understanding critical elements of the experience of life space. The material derived is discussed from the eerspectives of family systems, psychodynamic, and abuse treatment theories, with special reference to notions of family structure, boundary, the self, and memory. Emphasis is placed on the actual physical layout of the home, as well as the subjective experience of it. Applications of the drawing technique for exploring memories are illustrated. Case examples are presented from clinical trials with children and adults in residential treatment, inpatient, and outpatient settings.The Heller Financial Corporation generously supports the development of household and spatial drawings for treatment and prevention. A version of this paper was presented at the 43rd Annual Meeting of the American Association of Psychiatric Services for Children, New Orleans, February 26, 1992. The author wishes to thank Robert B. Bloom, Ph.D., Excutive Director of JCB, for supporting the development of ideas and techniques discribed in this paper.     

International migration and sustainable human development in eastern and southern Africa

International migration in eastern and southern Africa (ESA) is rarely addressed in population and development policies or regional organizations, and regional organizations must in the articulation of sustainable shared development identify the role of international migration. Poor quality data on international migration hampers analysis. Sustainable, shared, and human development within the region are subregional issues. Permanent migration is characterized among ESA countries as increasing demographic ethnic pluralism that may result in redrawing of territorial boundaries and further population movement. Portuguese and Arab settlement and integration in eastern areas resulted in coexistence, while European immigration to South Africa resulted in racial segregation. Modern colonial settlement and the aftermath of political conflict resulted in independent countries after the 1960s and outmigration of nonAfrican groups. Much of the labor migration in ESA is unskilled workers moving to South African mining regions. Labor migration to Zimbabwe and Zambia declined after the 1960s. The formation of the Common Market for ESA and the potential merger with the Preferential Trade Area and South African Development Community is a key approach to integration of migration into regional cooperation and shared development. Refugee movements create the most problems. Prior to 1992 ESA countries accounted for 83.4% of refugees, particularly in Mozambique, Ethiopia, and Somalia. Some countries blame poor economic performance on the deluge of refugees. Illegal migration is currently detected because of the required work permits, but the adoption of the Common Market would obscure this phenomenon. Human development is affected most by migrations related to drought, labor migration to strong economic areas, and return migration. The Inter-Governmental Authority on Drought and Development needs to become more active and establish better policies on nomadic and refugee movements and displaced populations. Movement of educated populations to countries lacking in trained and skilled human resources is a future challenge. Strategies of immigration should facilitate economic development.