Routine comprehensive inquiry for abuse: A justifiable clinical assessment procedure?

Routine inquiry regarding histories of sexual and physical abuse among psychiatric patients is not yet a commonly accepted practice for most mental health practitioners. While there is greater awareness regarding such trauma, the prevalence of abusive experiences in this patient population has not received adequate documentation in the literature. This study was conducted to determine the relevance of systematic inquiry for abuse. It examined the nature and magnitude of victimization in psychiatric in-patients. Findings revealed that approximately one-half of all patients experienced abuse while one-quarter encountered severe abuse. Victimization of males was substantiated at higher levels than previously documented. This research supports the position that systematic and extensive inquiry for all forms of abuse is a sound clinical assessment procedure.     

Mirroring and autonomy: The dual tasks of mothers

Theexperience of being a mother, of being the developmental partner for the pre-oedipal child, is complex and demanding. A woman must learn to balance her own needs and identity as a person with the child's need for appropriate merging and distancing. The child's own developmental push requires a constant shifting in the mother's balance between herself and the child. This article explores some of the factors involved in the mother's experience of her dual task, and some of the ways in which the mother's development as a person is reciprocally related to her child's developmental demands.She is in private practice and also a research consultant. Ms. Walter is in private practice and a consultant, Family Service of Montgomery County.     

A Review of the Current State of Negotiated Order Theory: an Appreciation and a Critique*

It is argued that the theory of negotiated order, which has remained largely submerged within a series of fairly specific “grounded” case studies of occupations, professions, and complex organizations in the health field, has a number of attractive qualities to it. As such, it represents one of the more exciting recent developments in the study of organizations The present paper examines the more recent historical origins of the theory, summarizes its major points, and critically assesses its strengths and weaknesses. Since most of the substance of the theory is found in studies of health professionals working in hospital settings, the examples used here are also derived from this particular body of literature. Some future possible directions which we believe will improve the overall explanatory power of the perspective are presented in the concluding section.