Controlling behaviour using neuroleptic drugs: the role of the Mental capacity act 2005 in protecting the liberty of people with dementia

The use of neuroleptic drugs to mediate the behaviour of people with dementia living in care homes can lead to them being deprived of their liberty. Whilst regulation has been successful in reducing neuroleptic prescribing in the USA, policy guidance has been unsuccessful in reducing the use of these drugs in the UK. Yet the Mental capacity act 2005 aimed to protect the liberty of people lacking capacity and provided safeguards to ensure that they are not inappropriately deprived of their liberty in institutions. This article highlights the potential for using this law to identify when neuroleptic prescribing in care homes would deprive people with dementia of their liberty and, in turn, to act as a check on prescribing levels. However, the extent to which the Act can promote and protect the right to liberty of people with dementia is constrained by a lack of access to social rights.     

Trust in complementary medicine: the case of cranial osteopathy

Trust has been seen as operating within situations in which an individual's ability to assess risk or probability is absent and yet they still choose to believe in something. The development of new sets of knowledge in modern societies raises interesting questions about how the public come to trust the ‘experts’ who practice them and there is a paucity of work which addresses how trust ‘happens’ in these new relationships. This paper uses the accounts of patients who use cranial osteopathy to discuss the bases of trust in complementary medicine. It is argued that the practitioner and their therapy is not the basis of patient trust. For the initial attendance the patient relies upon the accounts and credibility of other people (network trust). After this it is the phenomenological work of the patient, who strives to find meaning in the treatments they experience, which is essential to the development of trust relationships. The paper demonstrated that patients mobilise ideas and understandings which they are familiar with to understand the unfamiliar and that it is this process of seeking meaning which is central to the creation of trust.     

The Aboriginal People: Literary Perspectives

There continues to be a worrying lack of material about family therapy with Aborigines, despite the massive difficulties experienced by Aboriginal people. A notable exception has been from Geraldine Slattery, whose original paper Transcultural Therapy with Aboriginal Families: Working with the Belief System was published by the Journal in 1987. Here Geraldine reviews two recent publications by University of Queensland Press, which has a long record of publishing about our Aboriginal citizens. While these books are not specifically focused on family therapy, their central relevance will be obvious. — Editor.     

Gambling over the life course and treatment-seeking

The purpose of this study is to investigate change in gambling behaviours over the life course, and, correspondingly, the treatment-seeking behaviours of 86 people who met the criteria for at-risk (participants endorsing two to four items on the South Oaks Gambling Screen [SOGS]) and problem gamblers (participants endorsing five or more items on the SOGS) over the last five years. Data were obtained from informants during semi-structured interviews using Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and II), SOGS and treatment-seeking interviews. The results showed three groups of gambling behaviours over the life course. A first group started gambling early on and continued participating in recreational gambling until its participants were between 40 and 50 years of age, during which time they became problem gamblers. A second group transitioned from recreational gambling to problem gambling over a short period of time; its participants were aged between 40 and 50. Lastly, a third group which was exposed to gambling later on in life, mostly after retirement, developed gambling problems quickly. Psychopathology was prevalent in all groups, given that 98% suffered from a mental health problem during their life, and 62% within the last six months. Participants who made use of the services available mostly turned to medical and specialized mental services for brief periods, usually when in crisis. In terms of problem gambling, the results argue in favour of maintaining dedication toward treatment, especially in the presence of co-morbidity.     

The Equality Effects of the ‘Hyper‐formalization’ of Selection

This paper explores how formalization of employee selection procedures for the purpose of ensuring equality of opportunity can become so extensive that the intended outcome of fairness is undermined. Drawing on empirical evidence from a large media organization, the analysis reveals the detrimental impact of formalization in relation to the recruitment of ethnic minority staff. While the existing literature describes how, during recruitment of employees, the circumvention of formal equality procedures can occur through managerial neglect and manipulation, the analysis in this paper shows that, paradoxically, circumvention can also occur through compliance with procedures. This new category takes three forms (robotic, defensive and malicious) and appears under conditions of excessive formalization – the term hyper‐formalization is coined to describe this. The paper develops new concepts that add to understanding of the limitations of equality and diversity procedures, and brings fresh challenges to some of the liberal assumptions about the efficacy and desirability of formalization for achieving fairness.     

Social work,poverty, and child welfare interventions

The relationship between children's material circumstances and child abuse and neglect raises a series of questions for policy, practice, and practitioners. Children and families in poverty are significantly more likely to be the subject of state intervention. This article, based on a unique mixed‐methods study of social work interventions and the influence of poverty, highlights a narrative from practitioners that argues that, as many poor families do not harm their children, it is stigmatizing to discuss a link between poverty and child abuse and neglect. The data reveal that poverty has become invisible in practice, in part justified by avoiding stigma but also because of a lack of up‐to‐date research knowledge and investment by some social workers in an “underclass” discourse. We argue, in light of the evidence that poverty is a contributory factor in the risk of harm, that it is vital that social work engages with the evidence and in critical reflection about intervening in the context of poverty. We identify the need for fresh approaches to the harms children and families face in order to support practices that engage confidently with the consequences of poverty and deprivation.     

Pretrial Predictors of Judgments in the O. J. Simpson Case

Five hundred seventy-eight community college and four-year state university students responded to questionnaires designed to assess judgments regarding O. J. Simpson's guilt, beliefs surrounding the case, general attitudes, and background information. Although African Americans were more likely to perceive Simpson as innocent than non–African Americans, correlation analyses revealed that, for the most part, the same predictors explained African Americans' and non–African American's judgments of guilt. Finally, set-wise hierarchical regression analyses indicated that case-related beliefs that Simpson abused Nicole Brown Simpson and that the system was biased against him accounted for more significant incremental variance than did demographic variables such as age and ethnicity, personal experiences, and general attitudes. The results suggested that the racial polarization emphasized in public polls does not reflect the diversity of beliefs that existed within both African American and European American populations.     

ADHD in juvenile offenders: treatment issues nurses need to know

1. When working with juvenile offenders with ADHD, advanced practice nurses should consider prescribing stimulant medication in conjunction with other psychosocial interventions to achieve maximum treatment success. 2. Nurses working with young people with ADHD in the justice system must carefully coordinate care among all health care providers and juvenile justice personnel, including attorneys, probation/parole officers, and court assessment personnel. 3. Advocating for the individual needs of clients and their families is critical; often, this includes advocating for care that is not only evidence based, but also culturally competent.