Is Managed Mental Health Treatment Psychotherapy?

The corporate takeover of mental health treatment has dramatically affected mental health treatment. Two essential constituents of psychotherapeutic process, the relationship between patient and therapist and the special communicative process associated with a talking treatment, have been significantly compromised. Therapists and patients are being forced to consider whether in the absence of confidentiality, self determination, and a secure treatment partnership managed mental health care can be called psychotherapy. Drawing on several detailed sessions from the managed treatment of a young woman, the writer concludes that the answer is no.     

Statistical and Historical Analyses of Nations Which Deviate From the Size-Density Law

We examine nations which deviate significantly from the ?2/3 sizedensity slope previously observed for the aggregated political subdivisions of 98 modern nations and previously derived from the theory of timeminimization. We correct Stephan’s original list of deviant nations, demonstrate that all slopes more negative than ?2/3 were due to the erroneous inclusion of cities in the original data sets, develop a theory to account for the less negative deviant slopes, and test the theory both through statistical manipulation of current data and through analysis of available historical data.     

Perceived importance of “social goals” in business organizations

Business organizations operate within a complex socio-technical environment. Interactions between these socio-technical dimensions and the managers' personal value systems are thought to influence managerial role patterns and decisions. This paper investigates shifts in perceived importance of “social goals” from a set of organizational goals. The research concludes that there has been no significant changes occurring in either the ordering or the clustering of organizational goals.     

Quality improvement in patient distribution at a major university student health center

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

Naked reverse: unexpected plays for exceptional results

Following the herd is easy when it comes to business ventures. But if you really want to start something new, you must first carefully think it through. Learn some ways to do that before you set out on a new path.     

Casual sex among Australian schoolies

This study of the casual sexual partnering of 570 male and 776 female Australian high school students on a schoolies week vacation expands on earlier research on factors that influence the sexual activity of vacationing youth. Over 60% of the men and nearly 40% of the women who engaged in sexual intercourse during schoolies week did so with a casual partner. We used logistic regression to test an expanded version of Triandis Theory of Interpersonal Behavior (TIB) in explaining casual sexual partnering. Situational experiences (similar to what others have called situational disinhibition), prior sexual experiences and intentions (similar to what others have called spillover) influenced casual sexual partnering. Different causal pathways were demonstrated for men and women.     

Think they're drunk? Alcohol servers and the identification of intoxication

Despite alcohol server training programs and legal liability aimed at controlling intoxication, server intervention appears to be rare. Given the difficulty in assessing intoxication, it can be assumed that improvement in assessment skills would increase the likelihood of intervention. Unfortunately, little is known regarding practices servers use to identify intoxication. In order to build a more informed base for policy formation and server training, the focus of this inquiry was to examine practices used by servers to assess intoxication. The analysis was based upon questionnaires mailed to a random probability sample of licensed servers from one state (N = 822). Indicators found to be most important were examined in relation to a variety of occupational characteristics. Implications for training curricula, policy formation, and future research are discussed.     

Toward an index of gender equality

This paper develops a Gender Equality Index (GEI) that is modelled in its thinking and implementation on the Consumer Price Index (CPI). The GEI was computed using annual Ontario data on seven socioeconomic indicators for the years 1975 to 1984. The analysis supports the following conclusions: (1) that it is possible to indentify a subset of indicators that have face validity as measures of relative gender equality; (2) that factor analysis is a useful means for evaluating the construct validity of gender equality; (3) that the resulting GEI reveals a strong upward trend toward gender equality in the latter half of the 1970's and the early 1980's and (4) that this trend has flattened in 1984.     

Physician duties in the conduct of human subject research

In this article, I examine a skeptical argument against the possibility of ethically justifying risky human subject research (rHSR). That argument asserts that such research is unethical because it holds the possibility of wronging subjects who are harmed and whose consent to participate was less than fully voluntary. I conclude that the skeptical argument is not in the end sufficient to undermine the ethical foundation of rHSR because it fails to take account of the special positive duty researchers owe their clients and future patients. Although the skeptical argument is defeated, it exacts certain novel concessions from the pro‐research position. Of particular importance are the admissions (a) that researchers presumptively owe a fiduciary duty to research subjects, (b) that because the most important risks of rHSR are unknown and unquantifiable that duty must be explicitly waived by all subjects before they participate in any protocol, and (c) that such waivers must be made by individuals who satisfy objective criteria of competence for giving fully voluntary consent. The implementation of procedures responsive to these concerns might have a dampening effect on the conduct of research. However, the article concludes with a consideration of the likely benefits to researchers and society of a more cautious ethical regime.