Issues in Portability of Evidence-based Treatment for Adolescent Depression

Depression is one of the most commonly diagnosed psychiatric disorders among school-aged youth, with high prevalence and far-reaching consequences. However, even though there are two evidence-based practices for treating adolescent depression (Cognitive-Behavioral Therapy and Interpersonal Therapy), most adolescents referred for treatment are unlikely to receive either. In part, this is due to the difficulty of transporting an evidence-based practice from laboratory to real-world setting, and determining how to transport an empirically validated treatment has thus become a focus of concern for social work researchers and practitioners. A host of client, clinician, setting, and treatment delivery variables can influence portability. Taking all these factors into consideration is a daunting task—but less daunting if done at the onset, during the initial process of efficacy research, rather than afterward as a separate stage. The thesis of this paper is that the only solution to the problem of portability is a combined, rather than sequential, approach to treatment development in which effectiveness and application concerns are included in the original research design. A review of suggested approaches, as well as discussion of factors that contribute to variance in outcome, is followed by recommendations for future research.     

Gendering the Management of Change in Higher Education: A Case Study

This article reports an investigation into the influence of gender at a pre-1992 UK university. Interviews with Heads of Departments and others defined as occupying ‘middle management’ positions reveal three distinct stances to the new higher education, of ‘collaboration’, ‘resistance’ and ‘transformation’ and the article explores how gender influences these stances. It attempts to move beyond a simple focus on gender differences, towards answering Bacchi's (1990) call for ‘a more useful political analysis (which) would draw attention to the way in which the current economic system encourages certain behaviours and discourages others’. It shows that women academics are taking a transformational stance, but that the stances are not gender-specific. Gender is institutionally embedded with other organizational characteristics, such as academic discipline, departmental size, compatibility with external commercial activity, and the ability or otherwise to generate funds. Questions are raised about the contribution of such stances to the future of the new educational order.     

An Evaluation of a Child Guidance Clinic

An attempt is made to evaluate the effectiveness of a child guidance clinic. The outcome of the clinic's intervention was found to vary according to the nature of the presenting problem and the social class of the client. The categories of problems where treatment was ineffective are discussed in detail.     

Random regression models for human immunodeficiency virus ribonucleic acid data subject to left censoring and informative drop-outs

Objectives in many longitudinal studies of individuals infected with the human immunodeficiency virus (HIV) include the estimation of population average trajectories of HIV ribonucleic acid (RNA) over time and tests for differences in trajectory across subgroups. Special features that are often inherent in the underlying data include a tendency for some HIV RNA levels to be below an assay detection limit, and for individuals with high initial levels or high ranges of change to drop out of the study early because of illness or death. We develop a likelihood for the observed data that incorporates both of these features. Informative drop-outs are handled by means of an approach previously published by Schluchter. Using data from the HIV Epidemiology Research Study, we implement a maximum likelihood procedure to estimate initial HIV RNA levels and slopes within a population, compare these parameters across subgroups of HIV-infected women and illustrate the importance of appropriate treatment of left censoring and informative drop-outs. We also assess model assumptions and consider the prediction of random intercepts and slopes in this setting. The results suggest that marked bias in estimates of fixed effects, variance components and standard errors in the analysis of HIV RNA data might be avoided by the use of methods like those illustrated.     

CALIBRATING MEASURES OF FAMILY ACTIVITIES BETWEEN LARGE- AND SMALL-SCALE DATA SETS

Two studies of working families are combined to demonstrate a strategy for producing reliable estimates from the combination of self-reported (large N) and observational (small N) data. Both studies examine where and how dual-career families spend time at home. The 500 Family Study is sociological and uses self-reported time diary data from a national sample; the CELF study is anthropological and uses observational scan sampling data from a regional sample of 32 families. The data are combined as if they constitute one sample, and an analytic solution for establishing the reliability of the resulting composite estimates of time use is provided. Merging the data sets provides validation for each study, neither of which is without potential methodological weaknesses. The advantages of combining data from the independent data collection methods are discussed, and selected substantive findings on families' activities are highlighted, illustrating similarities and differences between findings in the independent and combined data sets. Results show that working families spend significant time in a small spectrum of home spaces, particularly kitchens and living rooms, with leisure activities prevailing, but mothers, fathers, and children differ in where and how they spend their time. Overall, a template for merging data from different disciplines and methods is provided.     

Ingesting the organization: The embodiment of organizational food rituals

This exploratory paper asks: ‘how do organizational food and drink rituals shape, reflect or create organizational culture?’ Adopting an embodied approach based on Merleau-Ponty's [1945. Phenomenology of Perception. Translated by C. Smith, 2003. London: Penguin. New York: Routledge] phenomenological work, this paper explores the significance of food-based rituals. Data were collected from different organizations using mixed methods and an embodied, reflexive approach – which is relatively novel in organizational research. Embodied experiences are potent, and this paper proposes that workplace food and drink rituals can powerfully influence perceptions of organizational culture. The unique contribution is in showing how embodied organizational rituals create and sustain organizational culture by using the pre-reflective moment of food ingestion to shape cognitive reconstructions of organizational culture. However, food rituals can be controlled and shaped by the organization to specifically influence employee perceptions of organizational culture. Control of food rituals can be perceived as a deliberate effort to create a constructive culture and encourage reciprocity through employee loyalty and effort.