Termination: When the therapist leaves

Despite an expansion of our knowledge about loss and grief little has been written on the experience and techniques employed during a forced termination. This article examines the theory, applications of theory, and transference/countertransference issues surrounding the author's experience as she moved to another state and transferred or terminated with her patients.Paper presented at the Fourteenth Annual Symposium of the New York Center for Psychoanalytic Training, March 1989.     

THE EFFECTIVENESS OF FAMILY INTERVENTIONS IN THE TREATMENT OF PHYSICAL ILLNESS

Although a large body of research demonstrates that the family has a powerful influence on physical health, the evidence for the effectiveness of family interventions in physical illness is less conclusive. Family therapy and other family interventions appear to be most effective in chronic childhood illnesses such as asthma and diabetes. Family interventions have also been shown to be effective in the management of some cardiovascular and neurologic disorders and for the treatment of obesity. Family therapy appears to be more effective than individual therapy for some groups of patients with anorexia nervosa. This research supports the increasingly important role of medical family therapy in the new health care system. Recommendations for future research are discussed.     

Assessing the impact of planned social change

It is a special characteristic of all modern societies that we consciously decide on and plan projects designed to improve our social systems. It is our universal predicament that our projects do not always have their intended effects. Very probably we all share in the experience that often we cannot tell whether the project had any impact at all, so complex is the flux of historical changes that would have been going on anyway, and so many are the other projects that might be expected to modify the same indicators.It seems inevitable that in most countries this common set of problems, combined with the obvious relevance of social science research procedures, will have generated a methodology and methodological specialists focused on the problem of assessing the impact of planned social change. It is an assumption if this paper that, in spite of differences in the forms of government and approaches to social planning and problem-solving, much of this methodology can be usefully shared — that social project evaluation methodology is one of the fields of science that has enough universality to make scientific sharing mutually beneficial. As a part of this sharing, this paper reports on program impact assessment methodology as it is developing in the United States today.     

George Herbert Mead on Intelligent Social Reconstruction*

Many thinkers have discussed the possibility of intelligent social reconstruction; but few have examined the nature of such reconstruction as closely as did George Herbert Mead. This paper explores Mead's analysis through his understanding of human nature and intelligence, his discussion of value conflicts and the possibility of their resolution by means of the community, and his recognition of the need for popular commitment as a necessary condition for any wide-spread success. While pointing to certain problems with his position, this paper concludes that there is a basic soundness to Mead's approach.     

Police-reported intimate partner violence during pregnancy: who is at risk?

The objective of this retrospective cohort study was to determine risk factors for police-reported intimate partner violence (IPV) during pregnancy among Seattle residents with a registered live birth or fetal death in Washington State. Logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals for the association between demographic, behavioral, and obstetric history risk factors and any, physical, and non-physical police-reported IPV. Significant risk factors for any police-reported IPV during pregnancy included unmarried status (aOR 2.36), public health program use (aOR 1.33), smoking or alcohol use during pregnancy (aORs 1.45 and 1.80, respectively), previous live birth (aOR 1.39), and previous spontaneous or induced abortion (aORs 1.39 and 1.34, respectively). Risk factors for physical IPV varied only slightly from those for any IPV, and fewer factors were associated with nonphysical IPV. Demographic, behavioral, and obstetric history risk factors are potential markers of IPV risk during pregnancy.