Values in the role of the family therapist: self determination and justice

Recently, there has been renewed interest in the role of values in family therapy. A number of theorists agree that there is an inherent ethical dimension in all forms of therapy, because therapy necessarily involves influencing others in accord with a set of values. In cultures that value self determination, a potential conflict arises between the therapist's inherent moral influence and protecting the client's self determination. This article identifies that dilemma and investigates how different treatment approaches resolve it as they attempt to promote justice in the family.     

Small employers and health benefits: findings from the 2002 small employer health benefits survey

Overall, 19 percent of small employers offering health benefits made changes to their health plan between 2001 and 2002. Sixty-five percent increased deductibles and co-pays; 35 percent switched insurers; 30 percent increased the employee share of the premium; and 29 percent cut back on the scope of benefits. Twenty-six percent increased the scope of benefits offered. Nearly one-quarter of small employers offering health benefits think their firm would change coverage and 3 percent think it would drop coverage if the cost were to increase an additional 5 percent. Most small employers offer sound business reasons for offering health benefits to workers. Many report that it helps with employee recruitment and retention, and increases productivity. More than three-quarters report that offering health benefits is "the right thing to do." Most small employers that do offer health benefits report that it has a positive impact on various aspects of the business, such as recruitment, retention, employee attitude and performance, employee health status, and the overall success of the business. Most small employers that do not offer health benefits tend to think that not offering them has no negative impact on the above aspects of their business or the overall success of the business. However, those not offering benefits are more likely than those offering them to report that most of their employees are high-turnover and stay on the job only a few months. Small employers that offer health benefits tend to be distinctly different from those not offering them. Worker income in firms not offering health benefits tends to be considerably lower than in firms that do offer them. Employers not offering health benefits are more likely than those offering them to have a smaller proportion of full-time employees, and employers that do not offer health benefits have a larger proportion of females, workers under age 30, and minority employees. Of small employers that offer dependent coverage, more than 40 percent report that workers do not take coverage for their dependents because the dependents have coverage from somewhere else, but 35 percent report that employees decline dependent coverage because they cannot afford the premiums. Many small employers that do not offer health benefits are potential purchasers. Eleven percent are either extremely or very likely to start offering health benefits in the next two years, and 22 percent are somewhat likely to start offering health benefits.     

Cultural perspectives of death,grief, and bereavement

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.     

Prevalence Rates of Youth Gambling Problems: Are the Current Rates Inflated?

While there is a general consensus in the literature that it is common for youth to gamble, considerable variability in the reported prevalence rates of youth problem gambling has been found. More recently, issues concerning the possible overestimation of these rates have been raised. Arguments underlying the proposition that problem gambling rates for youth are inflated are examined. It is acknowledged that more rigorous research is required, including the need for the development and refinement of current adolescent instruments and screening tools, agreement upon a gold standard criterion for adolescent problem gambling, and clarity of nomenclature issues. The advancement of scientific knowledge concerning the underlying risk factors associated with the onset and course of youth gambling involvement and the role of effective adolescent prevention and treatment programs will require these fundamental research questions to be addressed.     

认识活动辩证运动的逻辑起点：认识角度——认识活动辩证运动新论

认识活动“自己构成自己的道路” ,是由自身内在矛盾推动的辩证运动过程。实践对认识的决定作用必须通过制约和影响认识自身的内在矛盾才能实现。认识活动辩证运动的内在逻辑线索 ,是认识活动由其历史与逻辑统一的起点经中介条件向真理性认识结论辩证运动、系统演进的过程。为逻辑分析的需要 ,我们将这样的过程称之为一个“认识单元”。作为认识活动辩证运动的逻辑起点的认识角度及其丰富的内在规定性 ,在理论形态内在角度分析的方法论意义。     

Working with women in secure environments

1. Women's adverse experiences as patients in secure and other mental health services appear to reflect sexism in wider social and historical contexts. 2. A Women's Service Development Group in a medium secure unit in the United Kingdom has made improvements in services for female patients, including an independent advocacy and befriending service, a Well-Woman Clinic, and other gender-sensitive activities. 3. In general, services were evaluated positively by women. Some dissatisfaction primarily was related to activities, issues concerning seclusion, and the lack of a day area for women only. 4. Women had mixed views about their contact with male staff and patients. Because of this, policies and services in this and related areas should account for individual needs.     

A survey of problematic sexualized behaviors of children in the New York City Child Welfare System:estimates of problem, impact on services, and need for training

Forty-eight of 52 (92%) agencies contracted with the New York City Administration for Children's Services (ACS) responded to a survey about problematic sexualized behaviors (PSB) of children in different levels of care within the child welfare system. Results revealed that almost all agencies reported PSB within their foster boarding home and residential treatment centers. A majority of agencies perceived PSB to be a significant problem for which staff and families were not sufficiently trained. These findings highlight many avenues for advocacy, clinical intervention, and staff development.     

A Comparison of Gambling by Minnesota Public School Students in 1992, 1995, and 1998

The purpose of this study was to compare rates of gambling among Minnesota public school students between 1992, 1995, and 1998. The three samples included 75,806 students in the 9th and 12th grades in 1992; 73,897 9th and 12th grade students in 1995; and 78,564 9th and 12th grade students in 1998. Students were administered the Minnesota Student Survey, a 121-item, anonymous, self-administered, paper-and-pencil questionnaire that inquires about multiple behavioral domains, including gambling behaviors. The same questionnaire, with minor revisions to the gambling items, was administered in 1992, 1995, and 1998 to students in their classrooms by the Minnesota Department of Education. The results showed two opposite trends. On the one hand, fewer students gambled in 1998 than in 1995 and 1992. On the other hand, there was a small, but growing number of 12th grade students who gambled frequently. In terms of trends over time for specific games, the lottery showed a significant decline in the number of 9th grade students who played at all. There was also a significant increase in the number of 12th grade students who played the lottery weekly or more often. The findings that frequent lottery gambling has increased among 12th grade students and that underage gambling continues among these students, are both cause for concern. This is the first generation of youth to be exposed to widespread accessability to legalized gambling venues and gambling advertising. Legalized gambling may be a new "rite of passage" for some of today's youth. It will be important to continue to monitor youth gambling and to provide information and resources to assist youth in making healthy decisions about their gambling behavior.